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. 2025 Jul 15;15(1):25636.
doi: 10.1038/s41598-025-11329-8.

Global burden of cardiovascular disease due to low physical activity, 1990-2021

Nan Wu  1 , Jian Wang  1 , Yingchu Hu  1 , Tingsha Du  2 , Peng Shu  3 , Caijie Shen  4 , Xiaomin Chen  5
Affiliations

Global burden of cardiovascular disease due to low physical activity, 1990-2021

Nan Wu et al. Sci Rep. .

Abstract

We aimed to clarify the distribution of the spatiotemporal burden of Low physical activity (LPA)-related cardiovascular disease (CVD) at the global, regional, and national levels from 1990 to 2021. We systematically extracted Global Burden of Disease Study (GBD) 2021 data on CVD burden attributable to LPA from 1990 to 2021, stratified by Socio-demographic Index (SDI) quintiles and 21 GBD geographical regions. Three complementary metrics were employed: (1) Age-standardized death rate (ASDR) and (2) Disability-Adjusted Life Year (DALY) rate provided cross-sectional burden estimates, while (3) Estimated Annual Percentage Change (EAPC) quantified temporal trends in ASDR/DALY rates. The EAPC-derived trend patterns were further analyzed in conjunction with SDI levels and regional variations to identify disparities in physical inactivity-related CVD burden. The age-standardized DALY rate (EAPC = -1.30) and ASDR (EAPC = -1.41) for CVD attributable to LPA showed a decreasing trend from 1990 to 2021. The highest age-standardized DALY rate and ASDR per 100,000 population across all five SDI regions were observed in the Low-middle SDI region (111.53; 5.67). Among the 21 geographic regions and 204 countries, the highest age-standardized DALY rate and ASDR per 100,000 population for CVD attributable to LPA in 2021 were both reported in North Africa and the Middle East (211.62; 10.50), with Sudan having the highest rates (616.58; 24.56). The largest increase in the age-standardized DALY rate from 1990 to 2021 was observed in Southeast Asia (EAPC = 0.19), while the most substantial increase in ASDR was noted in Southern sub-Saharan Africa (EAPC = 0.44). Both the age- standardized DALY rate and ASDR increased the most in Lesotho (EAPC = 2.30; EAPC = 2.39). Although the global burden of CVD attributable to LPA has decreased from 1990 to 2021, the burden remains significant in low- and middle-income countries.

Keywords: Cardiovascular disease (CVD); Estimated annual percentage change (EAPC); Global burden of disease; Low physical activity (LPA).

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study is based on a publicly available database and does not require ethical approval.

Figures

Fig. 1
Fig. 1
EAPC of age-standardized rates of CVD due to Low physical activity from 1990–2021, by locations. (A) Age-standardized DALY rate (B) ASDR. DALY = disability adjusted life-year. ASDR = age standardized death rate.
Fig. 2
Fig. 2
Change rate of gender number of CVD due to Low physical activity in 204 countries in 2021, by countries and ages. (A) DALY rate (B) Death rate.
Fig. 3
Fig. 3
The relationship between age-standardized rates and SDI of global burden of CVD due to Low physical activity in 2021, by 204 countries. (A) Age-standardized DALY rate (B) ASDR. DALY = disability adjusted life-year. ASDR = age standardized death rate.
Fig. 4
Fig. 4
Age standardized rates of global burden of cardiovascular diseases due to Low physical activity in 2021, by locations. (A) Age-standardized DALY rate (B) ASDR. DALY = disability adjusted life-year. ASDR = age standardized death rate.
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References

    1. British Heart Foundation. Global heart & circulatory diseases factsheet. August (2022). https://www.bhf.org.uk/-/media/files/research/heart-statistics/bhf-cvd-s... sheet.pdf
    1. US Preventive Services Task Force et al. Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: US preventive services task force recommendation statement. JAMA324 (20), 2069–2075. 10.1001/jama.2020.21749 (2020). - PubMed
    1. Perry, A. S. et al. Physical activity over the lifecourse and cardiovascular disease. Circ. Res.132 (12), 1725–1740. 10.1161/CIRCRESAHA.123.322121 (2023). - PMC - PubMed
    1. Katzmarzyk, P. T., Friedenreich, C., Shiroma, E. J. & Lee, I. M. Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. Br. J. Sports Med.56 (2), 101–106. 10.1136/bjsports-2020-103640 (2022). - PMC - PubMed
    1. Guthold, R., Stevens, G. A., Riley, L. M. & Bull, F. C. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants [published correction appears in Lancet Glob Health. ;7(1):e36. doi: 10.1016/S2214-109X(18)30454-6]. Lancet Glob Health. 2018;6(10):e1077-e1086. (2019). 10.1016/S2214-109X(18)30357-7 - PubMed