Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;54(1):553-564.
doi: 10.1080/07853890.2022.2034932.

Projection of global burden and risk factors for aortic aneurysm - timely warning for greater emphasis on managing blood pressure

Xuewei Huang  1   2 , Zhouxiang Wang  2   3 , Zhengjun Shen  4   5 , Fang Lei  1   2 , Ye-Mao Liu  2   5 , Ze Chen  2   6 , Juan-Juan Qin  1   2 , Hui Liu  1   7 , Yan-Xiao Ji  2   3 , Peng Zhang  1   2 , Xiao-Jing Zhang  1   2 , Juan Yang  1   2 , Jingjing Cai  2   8 , Zhi-Gang She  1   2 , Hongliang Li  1   2   3   4
Affiliations

Projection of global burden and risk factors for aortic aneurysm - timely warning for greater emphasis on managing blood pressure

Xuewei Huang et al. Ann Med. 2022 Dec.

Abstract

Rationale: Aortic aneurysm (AA) is a serious condition that largely increases the risk of aortic dissection and sudden death. Exploring the global burden of disease and changes in risk factors for AA is essential for public health policy development.

Objective: To project the death burden from AA and its attributable risk factors in the following decade based on the epidemiological data over the past 30 years.

Methods and results: We analysed the death burden of AA and trends of four risk factors from 1990-2019 using the updated 2019 Global Burden of Disease study database by Joinpoint regression analysis. Furthermore, we project the AA-related death burden for the next decade using the Bayesian age-period-cohort model. This study discovered that the global burden of death attributable to AA began to increase after decreasing for two decades. This upward trend will continue in the subsequent decade (average annual percent change: 0.318%, 95% CI: 0.288 to 0.348). Meanwhile, the disease burdens in all economic regions except high-middle socio-demographic index (SDI) regions will continuously increase in the next decade, with the fastest acceleration in the low-middle SDI region (average annual percent change: 1.183%, 95% CI: 1.166 to 1.200). Notably, high systolic blood pressure will surpass the contribution of smoking to become the most important risk factor for mortality due to AA.

Conclusion: This study discovered a rebounding trend in the aortic aneurysm-related death burden globally. High systolic blood pressure will be the top risk factor attributed to death from AA. Therefore, it should be considered as the first-degree risk factor in the guidance of AA management and criteria for population-based screening programs.Key messagesThe death burden of aortic aneurysms is beginning to rebound globally, and the trend will continue for the next decade.High systolic blood pressure will replace smoking as the most important risk factor associated with aortic aneurysm death.

Keywords: Aortic aneurysm; global burden of disease; mortality rate; prediction; risk factor/global assessment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Aortic aneurysm (AA) death burden in different regions over the past 30 years and the next decade. (A) Trends in the number of death cases by gender in the different regions, 1990–2030. (B) Trends in age-standardized mortality rate (ASMR) by gender in the different areas from 1990–2030. (C) Relationship between ASMR in 2019 and socio-demographic index (SDI). (D) Relationship between annual percent change (APC) of ASMR for the most recent segment divided by Joinpoint regression analysis and SDI.
Figure 2.
Figure 2.
Age and sex differences in the burden of aortic aneurysm (AA) death. (A) Mortality in AA at different ages. (B) The ratio of AA age-standardized mortality rates (ASMR) in males to females. (C) The ratio of AA deaths by age in males to females. SDI: socio-demographic index.
Figure 3.
Figure 3.
The number of countries or regions with increasing or decreasing age-standardized mortality rate of aortic aneurysms in the past 30 years compared with the next 10 years among the 150 countries or regions where the projections were conducted. SDI: socio-demographic index.
Figure 4.
Figure 4.
Changes in risk factors associated with aortic aneurysm (AA) deaths in different regions. (A) Trends in the number of deaths related to AA risk factors in the different regions from 1990–2030. (B) Trends in age-standardized mortality rate (ASMR) associated with AA risk factors in the different regions from 1990–2030. All, all risk factors; Sodium, a diet high in sodium; HSBP: high systolic blood pressure; Lead: lead exposure; SDI: socio-demographic index.
Figure 5.
Figure 5.
Differences in risk factors associated with aortic aneurysm (AA) death by gender and age. (A) Sex differences in different regions from 1990–2030. (B) Age differences in 2019 and 2030. ASMR, age-standardized mortality rate; Percent, changes in the proportion of AA deaths attributable to risk factors; SDI: socio-demographic index.
See this image and copyright information in PMC

References

    1. Johnston KW, Rutherford RB, Tilson MD, et al. Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery J Vasc Surg. 1991;13(3):452–458. - PubMed
    1. Choke E, Vijaynagar B, Thompson J, et al. Changing epidemiology of abdominal aortic aneurysms in England and Wales. Circulation. 2012;125(13):1617–1625. - PubMed
    1. Clouse WD, Hallett JW, Jr Schaff HV, et al. Improved prognosis of thoracic aortic aneurysms. JAMA. 1998;280(22):1926. - PubMed
    1. Johansson M, Zahl PH, Siersma V, et al. Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study. Lancet. 2018;391(10138):2441–2447. - PubMed
    1. Anjum A, von Allmen R, Greenhalgh R, et al. Explaining the decrease in mortality from abdominal aortic aneurysm rupture. Br J Surg. 2012;99(5):637–645. - PubMed

Publication types