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Trend Dynamics of Rheumatic Heart Disease Burden, 1990-2019: Insights From Age-Period-Cohort Modeling and Projections
Zizheng Liu1,2,3,4,5, Zeye Liu6, Ziping Li1,2,3,4,5
1Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China.
Reviews in Cardiovascular Medicine
|February 9, 2026
Summary
Rheumatic heart disease (RHD) mortality is decreasing globally, but low-income regions face a disproportionate burden. Targeted interventions are crucial to address widening health disparities and sex differences in RHD.
Area of Science:
- Cardiovascular Epidemiology
- Global Health
- Autoimmune Diseases
Background:
- Rheumatic heart disease (RHD) significantly contributes to global cardiovascular mortality.
- Limited understanding of age-specific RHD mortality patterns across diverse regions exists.
- RHD is an autoimmune disease with substantial global health impact.
Purpose of the Study:
- Investigate RHD mortality and disability-adjusted life years (DALY) trends over three decades.
- Analyze modifiable risk factors associated with RHD.
- Forecast RHD mortality trends for the next decade and explore age-period-cohort effects.
Main Methods:
- Utilized Global Burden of Disease (GBD) 2019 data for RHD mortality and DALY.
- Employed age-period-cohort (APC) modeling to analyze demographic influences.
- Examined modifiable risk factors and projected future RHD mortality trends.
Main Results:
- Age-standardized RHD mortality rates showed negative net drift globally, except in low SDI regions.
- High systolic blood pressure identified as a major metabolic risk factor.
- Projections indicate a global RHD mortality reduction, but low-SDI regions will bear a substantial burden, with widening sex disparities.
Conclusions:
- Age, period, and birth cohort effects on RHD were positive globally, except in low SDI regions.
- Widening health disparities highlight an imminent RHD disease burden threat.
- Targeted interventions, improved healthcare access, and sex-sensitive strategies are essential for RHD burden alleviation, especially in low-SDI regions.
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