Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories

International Journal for Equity in Health

Research

Yu Fu¹  Penghong Deng²  Mingsheng Chen³  Lei Si⁴  Dong Wang⁵ 

[1] Nanjing Drum Tower Hospital, Nanjing, China;School of Health Policy & Management, Nanjing Medical University, Nanjing, China;School of Health Policy & Management, Nanjing Medical University, Nanjing, China;Center for Global Health, Nanjing Medical University, Nanjing, China;School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia;Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia;School of Public Administration, Nanjing University of Finance and Economics, Qixia District, 210023, Nanjing, China;

关键词: Cardiovascular disease;    Global burden of disease;    Disability adjusted life years;    Socioeconomic inequalities;    Concentration index;   

DOI  :  10.1186/s12939-023-01988-2

 received in 2023-04-03, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population’s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019.MethodsWe extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019.ResultsThe age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease.ConclusionsGlobally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3

Fig. 2

Fig. 2

Fig. 7

Fig. 2