Aortic aneurysm burden among young adults in China, 1990-2019: Data from Global Burden of Disease Database 2019_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Linbo ¹ , YU Hao ² , LIU Wentao ¹ , TANG Qi ¹ ,  SHI Sen ²

1. The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, 621000, P. R. China;
2. The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646099, P. R. China;

Corresponding author：

SHI Sen, Email: 50242042@qq.com

Keywords：

Aortic aneurysm; Young adults; Disease burden

DOI：

10.7507/1007-4848.202301051

Video：

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Objective To provide reference for the formulation of public health policies through exploring the disease burden of aortic aneurysm (AA) in young adults. Methods Following the general analytical strategies used in the Global Burden of Disease (GBD) study 2019, we analyzed sex-specific mortality rates and years of life lost (YLLs) among young adults AA in China from 1990 to 2019, compared with global and sociodemographic index（SDI) stratified of young adults AA. Joinpoint was used to analyze the time trend of AA burden among young adults men and women in China. To analyze the attributable risk factors of AA burden in young adults and explore its characteristics. Results Among young adults (15-39 years old) in China, the total of AA deaths in 2019 was 657 (95%UI 549-791), an increase of 16.9% compared with 1990. The mortality rate in 2019 was 0.13 per 100 000 person-years (95%UI 0.11-0.16), an increase of 30%. In 2019, a total of 36921 (95%UI 30 865-44 445) YLLs were produced by young adults in China, an increase of 13.21% compared with 1990. The YLLs rate was 7.42 per 100 000 person-years (95%UI 6.2-8.93), an increase of 24.92%. The male YLLs rate was 11.49 per 100 000 population years (95%UI 9.22-14.28), increasing by 35.18%; The female YLLs rate was 3.11 per 100 000 person-years (95%UI 2.36-3.98), a decrease of 3.12%. Both the AA mortality rate and YLLS in male young adults were higher than those in female, and the growth rate from 1990 to 2019 was significantly higher than that in female. Conclusion The disease burden of AA among young adults in China increased significantly from 1990 to 2019, mainly among males. The time trend of male and female AA YLLs in Chinese young adults was obviously inconsistent. The AA YLLs of Chinese male young adults were positively correlated with economic development and the progress of medical technology, and were in the process of gradual increase. The AA YLLs of Chinese female young adults were much lower than the average level, which was closely related to the low smoking rate.

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1. Stoecker JB, Wang GJ. Epidemiology of thoracoabdominal aortic aneurysms. Semin Vasc Surg, 2021, 34(1): 18-28.
2. Obel LM, Diederichsen AC, Steffensen FH, et al. Population-based risk factors for ascending, arch, descending, and abdominal aortic dilations for 60-74-year-old individuals. J Am Coll Cardiol, 2021, 78(3): 201-211.
3. Bossone E, Eagle KA. Epidemiology and management of aortic disease: Aortic aneurysms and acute aortic syndromes. Nat Rev Cardiol, 2021, 18(5): 331-348.
4. Huang X, Wang Z, Shen Z, et al. Projection of global burden and risk factors for aortic aneurysm—Timely warning for greater emphasis on managing blood pressure. Ann Med, 2022, 54(1): 553-564.
5. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990—2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
6. Hou X, Zhang F, Ye Z, et al. The burden of aortic aneurysm in China from 1990 to 2019: Findings from the Global Burden of Disease Study 2019. BMC Public Health, 2022, 22(1): 782.
7. Wang Z, You Y, Yin Z, et al. Burden of aortic aneurysm and its attributable risk factors from 1990 to 2019: An analysis of the Global Burden of Disease Study 2019. Front Cardiovasc Med, 2022, 9: 901225.
8. Sampson UK, Norman PE, Fowkes FG, et al. Global and regional burden of aortic dissection and aneurysms: Mortality trends in 21 world regions, 1990 to 2010. Glob Heart, 2014, 9(1): 171-180.
9. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med, 2000, 19(3): 335-351.
10. IMPROVE Trial Investigators. Comparative clinical effectiveness and cost effectiveness of endovascular strategy v open repair for ruptured abdominal aortic aneurysm: Three year results of the IMPROVE randomised trial. BMJ, 2017, 359: j4859.
11. Laine MT, Laukontaus SJ, Kantonen I, et al. Population-based study of ruptured abdominal aortic aneurysm. Br J Surg, 2016, 103(12): 1634-1639.
12. Melvinsdottir IH, Lund SH, Agnarsson BA, et al. The incidence and mortality of acute thoracic aortic dissection: Results from a whole nation study. Eur J Cardiothorac Surg, 2016, 50(6): 1111-1117.
13. Howard DP, Banerjee A, Fairhead JF, et al. Population-based study of incidence of acute abdominal aortic aneurysms with projected impact of screening strategy. J Am Heart Assoc, 2015, 4(8): e001926.
14. Umebayashi R, Uchida HA, Wada J. The aging population and research into treatments for abdominal aortic aneurysms. Acta Med Okayama, 2019, 73(6): 475-477.
15. Evangelista A, Isselbacher EM, Bossone E, et al. Insights from the international registry of acute aortic dissection: A 20-year experience of collaborative clinical research. Circulation, 2018, 137(17): 1846-1860.
16. Hanna L, Sounderajah V, Abdullah AA, et al. Trends in thoracic aortic aneurysm hospital admissions, interventions, and mortality in England between 1998 and 2020: An observational study. Eur J Vasc Endovasc Surg, 2022, 64(4): 340-348. 17 , Owens DK, Davidson KW, et al. Screening for abdominal aortic aneurysm: US preventive services task force recommendation statement. JAMA, 2019, 322(22): 2211-2218.
17. Wei L, Bu X, Wang X, et al. Global burden of aortic aneurysm and attributable risk factors from 1990 to 2017. Glob Heart, 2021, 16(1): 35.
18. Luo D, Deng J, Becker ER. Urban-rural differences in healthcare utilization among beneficiaries in China's new cooperative medical scheme. BMC Public Health, 2021, 21(1): 1519.
19. Wang W, Duan W, Xue Y, et al. Clinical features of acute aortic dissection from the Registry of Aortic Dissection in China. J Thorac Cardiovasc Surg, 2014, 148(6): 2995-3000.
20. Bae JW, Woo SI, Lee J, et al. mHealth interventions for lifestyle and risk factor modification in coronary heart disease: Randomized controlled trial. JMIR Mhealth Uhealth, 2021, 9(9): e29928.
21. Fowkes FG, Aboyans V, Fowkes FJ, et al. Peripheral artery disease: Epidemiology and global perspectives. Nat Rev Cardiol, 2017, 14(3): 156-170.
22. GBD 2019 Tobacco Collaborators. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990—2019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet, 2021, 397(10292): 2337-2360.

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