Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019,Journal of the American College of Cardiology

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Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019
Journal of the American College of Cardiology ( IF 24.0 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.jacc.2020.11.010
Gregory A Roth ₁ , George A Mensah ₂ , Catherine O Johnson ₃ , Giovanni Addolorato ₄ , Enrico Ammirati ₅ , Larry M Baddour ₆ , Noël C Barengo ₇ , Andrea Z Beaton ₈ , Emelia J Benjamin ₉ , Catherine P Benziger ₁₀ , Aimé Bonny ₁₁ , Michael Brauer ₁₂ , Marianne Brodmann ₁₃ , Thomas J Cahill ₁₄ , Jonathan Carapetis ₁₅ , Alberico L Catapano ₁₆ , Sumeet S Chugh ₁₇ , Leslie T Cooper ₁₈ , Josef Coresh ₁₉ , Michael Criqui ₂₀ , Nicole DeCleene ₂₁ , Kim A Eagle ₂₁ , Sophia Emmons-Bell ₃ , Valery L Feigin ₁ , Joaquim Fernández-Solà ₂₂ , Gerry Fowkes ₂₃ , Emmanuela Gakidou ₁ , Scott M Grundy ₂₄ , Feng J He ₂₅ , George Howard ₂₆ , Frank Hu ₂₇ , Lesley Inker ₂₈ , Ganesan Karthikeyan ₂₉ , Nicholas Kassebaum ₁ , Walter Koroshetz ₃₀ , Carl Lavie ₃₁ , Donald Lloyd-Jones ₃₂ , Hong S Lu ₃₃ , Antonio Mirijello ₃₄ , Awoke Misganaw Temesgen ₃ , Ali Mokdad ₃ , Andrew E Moran ₃₅ , Paul Muntner ₂₆ , Jagat Narula ₃₆ , Bruce Neal ₃₇ , Mpiko Ntsekhe ₃₈ , Glaucia Moraes de Oliveira ₃₉ , Catherine Otto ₁ , Mayowa Owolabi ₄₀ , Michael Pratt ₂₀ , Sanjay Rajagopalan ₄₁ , Marissa Reitsma ₄₂ , Antonio Luiz P Ribeiro ₄₃ , Nancy Rigotti ₄₄ , Anthony Rodgers ₄₅ , Craig Sable ₄₆ , Saate Shakil ₁ , Karen Sliwa-Hahnle ₃₈ , Benjamin Stark ₁ , Johan Sundström ₄₇ , Patrick Timpel ₄₈ , Imad M Tleyjeh ₄₉ , Marco Valgimigli ₅₀ , Theo Vos ₁ , Paul K Whelton ₅₁ , Magdi Yacoub ₅₂ , Liesl Zuhlke ₃₈ , Christopher Murray ₃ , Valentin Fuster ₅₃ ,

Affiliation

University of Washington, Seattle, Washington, USA.
National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland, USA.
University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Catholic University of Rome, Rome, Italy.
De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy.
Mayo Clinic, Rochester, Minnesota, USA.
Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
Boston University School of Public Health, Boston, Massachusetts, USA.
Essentia Health, Duluth, Minnesota, USA.
District Hospital of Bonassama-University of Douala, Douala, Cameroon.
University of British Columbia, Vancouver, British Columbia, Canada.
Medical University of Graz, Graz, Austria.
Newpath Partners LLC, Boston, Massachusetts, USA.
Telethon Kids Institute, Nedlands, Western Australia, Australia.
University of Milano, Milan, Italy.
Cedars-Sinai, Smidt Heart Institute, Los Angeles, California, USA.
Mayo Clinic, Jacksonville, Florida, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
University of California at San Diego, San Diego, California, USA.
The University of Michigan Samuel and Jean Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Barnaclinic+ Grup Hospital Clinic, Barcelona, Spain.
University of Edinburgh, Edinburgh, United Kingdom.
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Queen Mary University of London, London, United Kingdom.
University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Tufts Medical Center, Boston, Massachusetts, USA.
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.
National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA.
Ochsner Health, New Orleans, Louisiana, USA.
Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
University of Kentucky College of Medicine, Lexington, Kentucky, USA.
IRCCS Casa Sollievo della Sofferenza Hospital, Department of Medical Sciences, San Giovanni Rotondo, Italy.
Columbia University Irving Medical Center, New York, New York, USA.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
The University of Sydney School of Medicine, Sydney, New South Wales, Australia.
University of Cape Town, Cape Town, South Africa.
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
University of Ibadan, Ibadan, Oyo State, Nigeria.
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Stanford University School of Medicine, Stanford, California, USA.
Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Massachusetts General Hospital, Boston, Massachusetts, USA.
The George Institute for Global Health, Newtown, New South Wales, Australia; Imperial College of London, London, United Kingdom.
Children's National Hospital, Washington, DC, USA.
Uppsala University, Uppsala, Sweden.
Dresden University of Technology, Dresden, Germany.
King Fahd Medical City, Riyadh, Saudi Arabia.
Inselspital, University Hospital Bern, Bern, Switzerland.
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Imperial College of London, London, United Kingdom.
Icahn School of Medicine at Mount Sinai, New York, New York, USA; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.

中文翻译：

1990-2019 年全球心血管疾病负担和风险因素

心血管疾病 (CVDs)，主要是缺血性心脏病 (IHD) 和中风，是全球死亡的主要原因，也是导致残疾的主要原因。本文使用 2019 年全球疾病负担 (GBD) 研究的估计值回顾了 CVD 总负担的严重程度，包括 13 个心血管死亡的根本原因和 9 个相关风险因素。GBD 是一项正在进行的跨国合作，旨在提供可比和一致的估计随着时间的推移，人口健康，使用所有可用的关于发病率、患病率、病死率、死亡率和健康风险的人口水平数据来源，对 204 个国家和地区从 1990 年到 2019 年进行估计。总 CVD 的流行病例从 2.71 亿增加了近一倍。 95% 不确定区间 [UI]：257 到 2.85 亿）在 1990 年到 2019 年到 5.23 亿（95% UI：497 到 5.5 亿），CVD 死亡人数从 1990 年的 1210 万（95% UI：11.4 到 1260 万）稳步增加，到 2019 年达到 1860 万（95% UI：17.1 到 1970 万）。残疾调整生命年的全球趋势（ DALYs）和生命损失年数也显着增加，在此期间，残疾寿命翻了一番，从 1770 万（95% UI：12.9 到 2250 万）增加到 3440 万（95% UI：24.9 到 4360 万）。自 1990 年以来，因 IHD 导致的 DALY 总数稳步上升，2019 年达到 1.82 亿（95% UI：170 至 1.94 亿）DALY，914 万（95% UI：8.40 至 974 万）死亡，以及 1.97 亿（95% UI：178 至 2.2 亿）2019 年 IHD 流行病例。自 1990 年以来，中风导致的 DALY 总数稳步上升，达到 1.43 亿（95% UI：133 至 1.53 亿）DALY，655 万（95用户界面百分比：6。2019 年死亡人数为 00 至 702 万），2019 年中风流行病例为 1.01 亿（95% UI：93.2 至 1.11 亿）。心血管疾病仍然是世界疾病负担的主要原因。对于高收入国家以外的几乎所有国家来说，CVD 负担持续了长达数十年的上升，令人担忧的是，在高收入国家以前下降的一些地方，CVD 的年龄标准化率已经开始上升。如果世界要实现可持续发展目标 3 的具体目标并将非传染性疾病导致的过早死亡率降低 30%，则迫切需要重点实施现有的具有成本效益的政策和干预措施。心血管疾病仍然是世界疾病负担的主要原因。对于高收入国家以外的几乎所有国家来说，CVD 负担持续了长达数十年的上升，令人担忧的是，在高收入国家以前下降的一些地方，CVD 的年龄标准化率已经开始上升。如果世界要实现可持续发展目标 3 的具体目标并将非传染性疾病导致的过早死亡率降低 30%，则迫切需要重点实施现有的具有成本效益的政策和干预措施。心血管疾病仍然是世界疾病负担的主要原因。对于高收入国家以外的几乎所有国家来说，CVD 负担持续了长达数十年的上升，令人担忧的是，在高收入国家以前下降的一些地方，CVD 的年龄标准化率已经开始上升。如果世界要实现可持续发展目标 3 的具体目标并将非传染性疾病导致的过早死亡率降低 30%，则迫切需要重点实施现有的具有成本效益的政策和干预措施。CVD 的年龄标准化发病率在一些地方开始上升，而以前在高收入国家它是下降的。如果世界要实现可持续发展目标 3 的具体目标并将非传染性疾病导致的过早死亡率降低 30%，则迫切需要重点实施现有的具有成本效益的政策和干预措施。CVD 的年龄标准化发病率在一些地方开始上升，而以前在高收入国家它是下降的。如果世界要实现可持续发展目标 3 的具体目标并将非传染性疾病导致的过早死亡率降低 30%，则迫切需要重点实施现有的具有成本效益的政策和干预措施。

更新日期：2020-12-01

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