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. 2024 Jan 6;24(1):110.
doi: 10.1186/s12889-023-17573-9.

Persistence of severe global inequalities in the burden of Hypertension Heart Disease from 1990 to 2019: findings from the global burden of disease study 2019

Mengkai Lu #  1 , Dongxiao Li #  2 , Yuanlong Hu  3 , Lei Zhang  4 , Yuan Li  2 , Zhiyuan Zhang  1 , Chao Li  5
Affiliations

Persistence of severe global inequalities in the burden of Hypertension Heart Disease from 1990 to 2019: findings from the global burden of disease study 2019

Mengkai Lu et al. BMC Public Health. .

Abstract

Aims: Assessing the global burden and health inequalities of Hypertension Heart Disease (HHD) during the period from 1990 to 2019.

Methods: Secondary analysis of the Global Burden of Disease (GBD) study in 2019, focusing on the burden of diseases, injuries, and risk factors worldwide. Disability-Adjusted Life Years (DALYs) data related to HHD are extracted from the 2019 GBD. Inequality Slope Index (SII) and Concentration Index are calculated to assess health inequalities across regions and countries.

Results: The total DALYs for HHD reached 21.51 million, demonstrating a substantial increase of 54.25% compared to the figures recorded in 1990, while the age-standardized DALY rates per 100,000 population for HHD in 2019 showed a notable decline to 268.19 (95% UI 204.57, 298.07), reflecting a significant decrease of 26.4% compared to the rates observed in 1990. The DALYs rate of hypertensive heart disease increases with age. Countries with moderate SDI accounted for 38.72% of the global burden of HHD in terms of DALYs. The highest age-standardized DALY rates (per 100,000) are predominantly concentrated in underdeveloped areas. In 1990 and 2019, the SII (per 100,000 population) for DALYs were - 121.6398 (95% CI -187.3729 to -55.90684) and - 1.592634 (95% CI -53.11027 to 49.925) respectively. The significant decline suggests a reduction in the inequality of age-standardized burden of HHD between high-income and low-income countries during this period.

Conclusion: The unequal prevalence of HHD across different populations can hinder the achievement of the "health for all" objective. Persistent disparities in HHD have been observed globally over the past thirty years. It is crucial to prioritize efforts towards reducing avoidable health inequalities associated with hypertension-related heart disease, particularly in low-income and middle-income countries.

Keywords: DALYs; Global disease burden 2019; Health inequality; Hypertensive heart disease.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Global burden due to kinds of HHD by sex
Fig. 2
Fig. 2
The age distribution of the burden of HHD by sex in 1990 (A, B) and 2019 (C, D) expressed in DALYs (A, C) and DALY rates (B, D)
Fig. 3
Fig. 3
Spatial distribution of the burden of HHD, in terms of DALY in all age
Fig. 4
Fig. 4
Change in burden of HHD by region, 1990 vs. 2019
Fig. 5
Fig. 5
SII analysis. (A) Absolute income-­related healthy inequality in HHD burden, presented using regression lines, 1990 vs. 2019. (B) Trendline demonstrates the trend in SII from 1990 to 2019
Fig. 6
Fig. 6
Concentration index analysis. (A) Relative income-­related healthy inequality in HHD burden, presented using concentration curves, 1990 vs. 2019. (B) Trendline demonstrates the trend in concentration index from 1990 to 2019
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