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. 2023 May 12;13(5):e069397.
doi: 10.1136/bmjopen-2022-069397.

Global burden of cardiovascular disease attributable to metabolic risk factors, 1990-2019: an analysis of observational data from a 2019 Global Burden of Disease study

Shuyi Wu  1 , Wenlin Xu  1 , Chengfu Guan  1 , Meina Lv  2 , Shaojun Jiang  3 , Zhang Jinhua  4
Affiliations

Global burden of cardiovascular disease attributable to metabolic risk factors, 1990-2019: an analysis of observational data from a 2019 Global Burden of Disease study

Shuyi Wu et al. BMJ Open. .

Abstract

Objectives: An up-to-date, detailed global analysis of the current status of the metabolic-attributed cardiovascular disease (CVD) burden has not been reported. Therefore, we investigated the global burden of metabolic-attributed CVD and its association with socioeconomic development status over the past 30 years.

Methods: Data on the burden of metabolic-attributed CVD were taken from the 2019 Global Burden of Disease (GBD) study. Metabolic risk factors of CVD included high fasting plasma glucose, high low-density lipoprotein cholesterol (LDL-c), high systolic blood pressure (SBP), high body mass index (BMI) and kidney dysfunction. Numbers and age-standardised rates (ASR) of disability-adjusted life-years (DALYs) and deaths were extracted and stratified by sex, age, Socio-demographic Index (SDI) level, country and region.

Results: The ASR of metabolic-attributed CVD DALYs and deaths decreased by 28.0% (95% UI 23.8% to 32.5%) and 30.4% (95% UI 26.6% to 34.5%), respectively, from 1990 to 2019. The highest burden of metabolic-attributed total CVD and intracerebral haemorrhage was mainly in low SDI locations, while the highest burden of ischaemic heart disease and IS was mainly in high SDI locations. The burden of DALYs and deaths in CVD was higher in men than women. In addition, the number and ASR of DALYs and deaths were highest in those over 80 years old.

Conclusion: Metabolic-attributed CVD threatens public health, especially in low-SDI locations and among the elderly. Low SDI location should strengthen the control of metabolic factors such as high SBP, high BMI, and high LDL-c and increase the knowledge of metabolic risk factors for CVD. Countries and regions should enhance screening and prevention of metabolic risk factors of CVD in the elderly. Policy-makers should use 2019 GBD data to guide cost-effective interventions and resource allocation.

Keywords: cardiac epidemiology; epidemiology; health policy; ischaemic heart disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The ASR of DALYs attributed to metabolic-related CVD per 100 000 person-years by country and territory from 1990 to 2019. (A) CVD. (B) Ischaemic heart disease. (C) Ischaemic stroke. (D) Intracerebral haemorrhage. ASR, age-standardised rate; CVD, cardiovascular disease; DALYs, disability-adjusted life-year.
Figure 2
Figure 2
The ASR of deaths attributed to metabolic-related CVD per 100 000 person-years by country and territory from 1990 to 2019. (A) CVD. (B) Ischaemic heart disease. (C) Ischaemic stroke. (D) Intracerebral haemorrhage. ASR, age-standardisad rate; CVD, cardiovascular disease.
See this image and copyright information in PMC

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