Analysis of the Changing Trend of the Burden of Rheumatic Heart Disease in China from 1990 to 2021

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Objective: This study aims to provide an accurate quantitative analysis of the burden of rheumatic heart disease in China, and to provide a scientific basis for the formulation of effective prevention and control strategies. Methods: Based on the latest public database 2021 Global Burden of Diseases (GBD2021), the characteristics and trends of incidence, prevalence, mortality, and attributable risk factors of rheumatic heart disease in the Chinese population from 1990 to 2021 were quantitatively analyzed. Results: From 1990 to 2021, the incidence of rheumatic heart disease in China decreased from 620,195 to 445,472, with an average annual decrease rate of 1.07%. The incidence rate decreased from 52.72/100,000 to 31.31/100,000 with an average annual decrease rate of 1.65%, while the age-standardized incidence rate decreased from 48.92/100,000 to 39.86/100,000 with an average annual decrease rate of 0.46%. The number of cases increased slightly from 8,923,639 to 9,073,096, with an average annual growth rate of 0.28%, and the prevalence decreased from 758.75/100,000 to 637.72/100,000 with an average annual decrease rate of 0.31%. The age-standardized prevalence decreased from 708.27/100,000 to 619.85/100,000 with an average annual decrease rate of 0.21%. The number of deaths decreased from 134,208 to 78,910, with an average annual decrease rate of 1.98%, and the mortality rate decreased from 11.41/100,000 to 5.51/100,000 with an average annual decrease rate of 2.55%. The age-standardized mortality rate decreased significantly from 19.07/100,000 to 5.00/100,000 with an average annual decrease rate of 5.00%. These data show that although the number of cases increased slightly, the incidence rate, prevalence rate, mortality rate, and age-standardized rates all showed a downward trend. Conclusion: From 1990 to 2021, the burden of rheumatic heart disease in China has undergone significant changes. Although the number of cases increased slightly, the incidence rate, prevalence rate, mortality rate, and age-standardized rates all showed a downward trend. Specifically, the incidence rate decreased from 52.72/100,000 to 31.31/100,000, indicating a significant decrease in the number of new cases of rheumatic heart disease per 100,000 people. The decrease in prevalence rate, from 758.75/100,000 to 637.72/100,000, reflects a decrease in the proportion of the population with rheumatic heart disease. The most significant decrease is in the mortality rate, from 11.41/100,000 to 5.51/100,000, indicating a substantial reduction in the risk of death from rheumatic heart disease. These changes may be attributed to the continuous progress in healthcare services, implementation of public health policies, and increased population health awareness in China. In addition, advances in medical technology, improvements in emergency systems, and optimization of cardiovascular disease management have also played an important role in reducing mortality rates. However, the slight increase in the number of cases suggests that despite significant progress, rheumatic heart disease remains an important challenge in the field of public health in China, requiring continuous attention and intervention.