LDL-C-Related Cardiovascular Burden in China 2010 to 2030: Spatiotemporal Patterns and Scenario-Based Projections.

Area of Science:

• Cardiovascular epidemiology
• Public health research
• Preventive medicine

Background:

• Previous research quantified high low-density lipoprotein cholesterol (LDL-C) burden globally and in high-income nations.
• The specific disease burden attributed to high LDL-C in China remains incompletely understood.

Purpose of the Study:

• To systematically evaluate the disease burden of high LDL-C in China between 2010 and 2020.
• To project the disease burden attributable to high LDL-C in China up to 2030.

Main Methods:

• Utilized a population-based study design with data from 644,189 adults across three large-scale, representative surveys.
• Employed a comparative risk assessment approach to quantify deaths and years of life lost due to high LDL-C.
• Conducted decomposition analysis to identify drivers of changes in attributable deaths and used a proportional change model for 2030 projections under various LDL-C control scenarios.

Main Results:

• In 2020, the age-standardized LDL-C level was 112.33 mg/dL (2.91 mmol/L).
• Attributable deaths and years of life lost were estimated at 813.53 thousand and 16,108.31 thousand, respectively.
• Between 2010 and 2020, the age-standardized mortality rate increased by 34.41%, and the number of deaths by 94.02%, driven by rising LDL-C levels, population growth, and aging. Projections indicate a potential doubling of the mortality rate by 2030 without intervention; a 10% LDL-C reduction is needed to decrease mortality.

Conclusions:

• High LDL-C presents a substantial public health challenge in China.
• The escalating mortality burden necessitates immediate, population-wide LDL-C control strategies.
• Expansion of national statin treatment coverage is crucial for addressing this growing health issue.