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. 2025 Apr 25:zwaf266.
doi: 10.1093/eurjpc/zwaf266. Online ahead of print.

Global, regional, and national perspectives on aortic aneurysm burden from 1992 to 2021: temporal patterns and age-period-cohort analyses

Jian Tang  1 , Xue-Er Cheng  1 , Yi-Sheng He  1 , Man Ge  1 , Qian-Qian Shi  1 , Xiao-Xiao Li  1 , Hai-Fen Wei  1 , Yan-Yu Zhu  1 , Hai-Feng Pan  1 , Peng Wang  2
Affiliations

Global, regional, and national perspectives on aortic aneurysm burden from 1992 to 2021: temporal patterns and age-period-cohort analyses

Jian Tang et al. Eur J Prev Cardiol. .

Abstract

Aims: To assess the global, regional, and country-specific trends in the burden of Aortic aneurysm (AA) from 1992 to 2021, with a focus on mortality rates, disability-adjusted life years (DALYs), and sociodemographic inequalities.

Methods: The Global Burden of Disease (GBD) 2021 study data were utilized to calculate the age-standardized mortality rates (ASMR) and disability-adjusted life year rates (ASDR) for AA in 204 countries. Temporal patterns were assessed using Joinpoint regression and age-period-cohort modeling. Cross-country inequalities were evaluated using the Slope Index of Inequality (SII) and Concentration Index.

Results: Globally, the disease burden of AA showed a downward trend. The ASMR for AA decreased from 2.57 per 100,000 (95% UI: 2.37, 2.72) in 1992 to 1.86 per 100,000 (95% UI: 1.67, 2.00) in 2021 (EAPC: -1.36%). The age effect indicated that the age-specific mortality rate sharply escalates with age, but opposite trends exist in period and cohort effects. The gender-specific analysis confirmed a consistently higher burden in males, with more pronounced reductions in high Socio-demographic Index (SDI) regions. Cross-country analyses highlighted widening absolute inequalities (SII: 74.4 to 84.1) but reduced relative inequalities (Concentration Index: 0.48 to 0.28) over time.

Conclusion: There is a downward trend in the global burden of AA from 1992 to 2021, with significant disparities observed across genders, age groups, and SDI regions. These findings emphasize the need for prevention through base healthcare services, risk factor management, and equitable access to interventions to effectively address the disproportionate AA burden.

Keywords: Age-period-cohort analysis; Aortic aneurysm; Disease burden; Health inequalities analysis; Temporal trends.

Plain language summary

This study used aortic aneurysm (AA)-related data in the GBD 2021 database from 1992 to 2021. Using Joinpoint regression, age-period-cohort model, and cross-national inequality analysis, it comprehensively and multi-dimensionally demonstrated the dynamic trends and health disparities in the burden of AA at the global, regional, and national levels. The findings indicate a global decline in the burden of AA, with males experiencing a relatively higher burden and disease prevalence increasing with age. Notably, while the burden of AA remains severe in high-SDI regions, it rises annually in low- and lower-middle-SDI regions. Furthermore, the absolute health inequality gap between countries is progressively widening.

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