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. 2025 Feb 13;15(1):25.
doi: 10.1007/s44197-025-00369-y.

Global Epidemiology of Early-Onset Aortic Aneurysm: Temporal Trends, Risk Factors, and Future Burden Projections

Heng Wang #  1   2 , Yaling Li #  2 , Keyi Fan #  2 , Taoran Zhao  1   3   4 , Keyang Xu  5 , Mayeesha Zahin  1 , Shule Wang  6 , Genmao Cao  7 , Tingting Gao  2 , Xiaohua Jia  8 , Ruijing Zhang #  9 , Honglin Dong #  10 , Guoping Zheng #  11   12
Affiliations

Global Epidemiology of Early-Onset Aortic Aneurysm: Temporal Trends, Risk Factors, and Future Burden Projections

Heng Wang et al. J Epidemiol Glob Health. .

Abstract

Background: Aortic aneurysm has a subtle onset, high rupture mortality, rapid progression in younger individuals, and increasing annual mortality rates. Our study aimed to estimate the global burden and trends of early-onset aortic aneurysm from 1990 to 2021.

Methods: Participants aged 15-39 years from 204 countries and regions (Global Burdern of Disease, GBD) from 1990 to 2021.The primary assessment indicators include age-standardized death rates (ASDR), age-standardized disability-adjusted life years rates (ASDALYR), annual average percent change (AAPC), attributable risk factor proportions, slope index, concentration index, and predictive model for early-onset aortic aneurysm.

Results: From 1990 to 2021, the ASDR for aortic aneurysm in adolescents and young adults increased from 0.12 (95% confidence interval [CI] 0.11, 0.14) to 0.13 (0.11, 0.14) per 100,000 population, with an AAPC of 0.08% (-0.08%, 0.25%). The ASDALYR rose from 7.25 (6.52, 8.30) to 7.35 (6.51, 8.37), with an AAPC of 0.07% (-0.09%, 0.23%). Both ASDR and ASDALYR are higher in males than females, with a declining trend in females. Higher Socio-Demographic Index (SDI) countries exhibit higher ASDR and ASDALYR compared to lower SDI countries, with a continuous decline observed in high SDI nations. Smoking remains the top risk factor, with population growth being the primary driver. Models predict a global increase in aortic aneurysm deaths, predominantly among males.

Conclusion: The overall burden of early-onset aortic aneurysms has exhibited an increasing trend over the last three decades, especially in lower SDI countries. There is an urgent need to develop targeted prevention and control strategies across different regions and countries worldwide.

Keywords: Disability-adjusted life years; Early-onset aortic aneurysm; Epidemiology; Global burden of disease.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: Not applicable. Consent for Publication: Not applicable. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The distribution of the disease burden of early-onset aortic aneurysm across countries and regions globally in 2021. (A) The global distribution of age-standardized death rates (ASDR) for early-onset aortic aneurysm. (B) The global distribution of age-standardized disability-adjusted life years rate (ASDALYR) for early-onset aortic aneurysm
Fig. 2
Fig. 2
The trends in age-standardized death rates (ASDR) and age-standardized disability-adjusted life years rate (ASDALYR) for early-onset aortic aneurysm across 21 GBD regions from 1990 to 2021
Fig. 3
Fig. 3
The trends in attributable risk factors for early-onset aortic aneurysm across the five SDI regions from 1990 to 2021. (A) The temporal trends in attributable risk factors for age-standardized death rates (ASDR) and age-standardized disability-adjusted life years rate (ASDALYR) of early-onset aortic aneurysm in females. (B) The temporal trends in attributable risk factors for ASDR and ASDALYR of early-onset aortic aneurysm in males
Fig. 4
Fig. 4
Decomposition analysis of early-onset aortic aneurysm. The black dots represent the overall difference means that the increase in deaths from 1990 to 2021. The bars in different colors illustrate the contributions of changes in age structure, population growth, and epidemiological changes to the overall increase in deaths of early-onset aortic aneurysm
Fig. 5
Fig. 5
Global health inequity analysis of early-onset aortic aneurysm. (A, B) Slope index of age-standardized death rates (ASDR) and age-standardized disability-adjusted life years rate (ASDALYR) for early-onset aortic aneurysm globally in 1990 and 2021. (C, D) Concentration index of ASDR and ASDALYR for early-onset aortic aneurysm globally in 1990 and 2021. The absolute health inequity measure is the slope index, while the relative health inequity measure is the concentration index
Fig. 6
Fig. 6
Projected deaths numbers and rates for early-onset aortic aneurysm in 21 GBD regions by 2045. (A) The bar charts represent the number of deaths (left y-axis), while the line graphs represent the mortality rates (right y-axis). (B) The lines from top to bottom represent the age groups: 35–39 years, 30–34 years, 25–29 years, 20–24 years, and 15–19 year
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