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Global burden and projections of cardiometabolic diseases attributable to high alcohol use: a comparative risk
Yuqing Tang1, Derong Lin1, Honglin Xu1
1Dongguan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Dongguan, China.
Insights
High alcohol use (HAU) drives increasing cardiometabolic disease (CMD) deaths, particularly type 2 diabetes mellitus (T2DM) in males and lower-income regions. Projections indicate a substantial rise in HAU-attributable CMD deaths by 2040.
Area of Science:
- Global Health Epidemiology
- Cardiovascular Research
- Metabolic Disease Research
Background:
- Cardiometabolic diseases (CMDs), encompassing cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), represent significant global health burdens.
- High alcohol use (HAU) is a key modifiable risk factor contributing to CMDs.
- Understanding trends in HAU-attributable CMDs is crucial for public health interventions.
Purpose of the Study:
- To quantify global, regional, and temporal trends in CMD burdens attributed to HAU from 1990 to 2021.
- To project future trends in HAU-attributable CMD burdens up to 2040.
- To assess disparities in HAU-attributable CMD burdens across different regions and demographic groups.
Main Methods:
- Analysis of Global Burden of Disease 2021 (GBD 2021) estimates for 204 countries and territories.
- Quantification of HAU-attributable deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASMRs, ASDRs).
- Utilized Bayesian age-period-cohort modeling for trend analysis and projections, assessing associations with the Sociodemographic Index (SDI).
Main Results:
- Despite a global decline in HAU exposure, HAU-attributable deaths and DALYs for CVD and T2DM increased between 1990 and 2021.
- HAU-attributable T2DM burden showed an increasing trend (ASMR: 0.48, ASDR: 1.83), especially in low- and middle-SDI regions.
- Projections suggest a substantial rise in HAU-attributable deaths by 2040 (CVD: ~70%, T2DM: ~3-fold), with widening sex disparities.
Conclusions:
- The burden of CMDs linked to HAU is escalating, particularly T2DM, affecting males and populations in lower-middle SDI regions.
- Urgent need for region-specific interventions and enhanced alcohol control policies.
- Addressing HAU is critical to mitigate the growing global burden of cardiometabolic diseases.
Background And Aims:
Cardiometabolic diseases (CMDs), including cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), remain major global health challenges. High alcohol use (HAU) is a modifiable risk factor. This study quantified the global, regional, and temporal trends in the burdens of CMDs attributable to HAU from 1990 to 2021 and projected trends to 2040.
Methods And Results:
Global Burden of Disease 2021 (GBD 2021) estimates for 204 countries and territories were analyzed to quantify HAU-attributable deaths, disability-adjusted life years (DALYs), and age-standardized mortality and DALY rates (ASMRs, ASDRs). HAU-attributable burdens were interpreted as model-based scenario estimates under the GBD 2021 comparative risk assessment framework, and not as individual-level causal effects. Associations with the Sociodemographic Index (SDI) were assessed. Trends in rates were summarized using estimated annual percentage change (EAPC) as a descriptive metric derived from log-linear regression on GBD age-standardized rate estimates, and projections were generated with a Bayesian age-period-cohort model. Although global HAU exposure declined, HAU-attributable deaths and DALYs from CVD and T2DM increased, with higher burdens among males and middle-aged adults. From 1990 to 2021, EAPCs based on age-standardized rates suggested modest declines in HAU-attributable CVD-related ASMR and ASDR (-1.53 and -1.31), whereas HAU-attributable T2DM ASMR and ASDR showed an overall increasing tendency (0.48 and 1.83), particularly in low- and middle-SDI regions. Eastern and Central Europe had the highest HAU-attributable CVD burden; Oceania and Central Latin America had the highest T2DM burden. By 2040, under a business-as-usual continuation of recent trends, scenario-based projections suggest that deaths attributable to HAU could rise substantially (on the order of 70% for CVD and nearly three-fold for T2DM), with widening sex disparities and greater quantitative uncertainty for CVD than for T2DM.
Conclusion:
Despite declining alcohol exposure, the burden of CMDs attributable to HAU is escalating-especially for T2DM, males, and populations in low and middle SDI regions. Region-specific interventions and stronger alcohol-control policies are urgently needed.
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