Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease Study 2021

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Ischemic heart disease (IHD) continues to be the foremost contributor to global morbidity and mortality. This analysis aims to report an updated assessment of prevalence, deaths, and disability-adjusted life years (DALYs) due to IHD and its attributable risk factors in 204 countries and territories from 1990 to 2021, by age, sex, and socio-demographic index (SDI). This analysis used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. IHD was defined as acute myocardial infarction, chronic stable angina, chronic IHD, and heart failure due to IHD. Major indicators used in this study were prevalence, death and DALYs. All estimates were reported as absolute counts and age-standardized rates per 100,000 population, along with their 95% uncertainty intervals (UIs). Globally, IHD accounted for 254.3 (95%UI: 221.4 to 295.5) million prevalent cases, 9.0 (95%UI: 8.3 to 9.5) million deaths and 188.4 (95%UI: 177.0 to 198.1) million DALYs in 2021. There was a noticeable decline in the global age-standardized death rate (ASDR) [-31.6% (95%UI: -34.9 to -28.3)] and age-standardized DALYs (ASRDALYs) [-28.8% (95%UI: -32.5 to -25.2)] from 1990 to 2021, with an estimated annual percentage change of -1.3 (95%CI: -1.34 to -1.26) and - 1.2 (95%CI: -1.25 to -1.16), respectively. In 2021, the global prevalence, death, and DALY rates of IHD were higher among males across all age groups, while death and DALY rates reaching a peak in the oldest group for both sexes. Regionally, we found a nonlinear but negative association between age-standardized prevalence rate (ASPR) and SDI. Nationally, similar negative associations were observed between ASRDALYs and SDI. High systolic blood pressure and high low-density lipoprotein cholesterol were the factors contributing most to the deaths and DALYs due to IHD. Despite declining global age-standardized death and DALYs rates of IHD, sustained multilevel prevention strategies remain essential. This requires population-wide risk factor reduction, targeted interventions for high-risk populations, and strengthened community healthcare networks to ensure accessible, guideline-based management.

We recently read the article by Shin YH et al., utilizing the Global Burden of Disease Study (GBD) 2019 to analyze the trends in the global burden of asthma and atopic dermatitis (AD) from 1990 to 2021 [1]. This study found that while the total number of cases has been increasing, the age-standardized prevalence rates have been declining. Given that the GBD has been updated to the 2021 version [2], it is essential to uncover the latest burden of asthma and AD. Therefore, we analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for asthma and AD, focusing exclusively on the data from 2021. Specifically, we conducted a cross-sectional analysis of the age-, sex-, and socio-demographic index (SDI)-specific burden, which is crucial for understanding the burden and informing strategies for prevention, control, and treatment. It is important to note that the GBD does not provide mortality data for AD. Consequently, our analysis and the presented figures do not include mortality data for this condition. In 2021, the highest age-standardized prevalence (ASP) and age-standardized incidence rate (ASIR) for asthma were observed in the High-income North America region, whereas the highest age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) were reported in the Oceania region. For AD, the highest ASP, ASIR, and ASDR were all recorded in the High-income Asia Pacific region (Figure 1; Figure S1). In terms of age distribution, the ASP and ASIR of asthma are primarily concentrated in children and adolescents, whereas the ASMR and ASDR are predominantly observed in the elderly population. In contrast, the disease burden of AD is mainly concentrated in children and adolescents (Figure 2). Regarding gender differences, no significant disparities are observed in the burden of asthma between males and females. However, the burden of AD is notably higher in females compared with males, which may be attributed to multifaceted etiology, encompassing culturally idealized expectations of appearance for females, hormonal influences such as the impact of sex hormones on immune responses and skin barrier function and genetic predispositions with a spotlight on filaggrin gene mutations (Figure 2) [3-5]. When stratified by SDI, the ASP and ASIR of asthma are significantly higher in high-SDI regions than in low-SDI regions, whereas the ASMR and ASDR of asthma are markedly higher in low-SDI regions than in high-SDI regions, which is due to limited access to and affordability of essential asthma treatment medications, leading to severe morbidity [6]. On the contrary, the disease burden of AD is predominantly concentrated in high-SDI regions (Figure S2). Overall, our study underscores the heterogeneity in the burden of asthma and AD across different age groups, genders, and socio-demographic regions. Addressing these disparities requires targeted strategies that consider the specific drivers of burden in each context. For asthma, this should include improving access to preventive care and treatment in lower-income regions, while for AD, interventions aimed at early childhood may be most effective. Additionally, to effectively manage AD, key interventions include regular moisturization to maintain skin hydration and the use of emollients to repair the skin barrier. It is also crucial to avoid irritants and allergens, modify bathing practices by using lukewarm water and gentle, fragrance-free cleansers, and consider environmental controls such as maintaining optimal indoor humidity levels to prevent skin dryness and irritation. Our findings highlight the importance of context-specific interventions and underscore the need for continued monitoring and research to effectively reduce the burden of these common allergic diseases. We appreciate the excellent works by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 collaborators. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. Data sources and code used in the Global Burden of Disease Study 2021 are available on the internet (http://ghdx.healthdata.org/gbd-results-tool). The data presented is unpublished elsewhere and are not duplicated. Figure S1. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in 21 GBD regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Figure S2. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in five SDI regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

High BMI (Body Mass Index) is a significant factor impacting health, with a clear link to an increased risk of leukemia. Research on this topic is limited. Understanding the epidemiological trends of leukemia attributable to high BMI risk is crucial for disease prevention and patient support. We obtained the data from the Global Burden of Disease Study, analyzing the ASR (age-standardized rates), including ASDR (age-standardized death rate) and age-standardized disability-adjusted life years (DALYs) rate, and estimated annual percentage change (EAPC) by gender, age, country, and region from 1990 to 2019. In 2019, deaths and DALYs have significantly increased to 21.73 thousand and 584.09 thousand. The global age-standardized death and DALYs rates have slightly increased over the past 30 years (EAPCs: 0.34 and 0.29). Among four common leukemia subtypes, only CML (Chronic Myeloid Leukemia) exhibited a significant decrease in ASDR and age-standardized DALYs rate, with EAPC of -1.74 and -1.52. AML (Acute Myeloid Leukemia) showed the most pronounced upward trend in ASDR, with an EAPC of 1.34. These trends vary by gender, age, region, and national economic status. Older people have been at a significantly greater risk. Females globally have borne a higher burden. While males have shown an increasing trend. The regions experiencing the greatest growth in ASR were South Asia. The countries with the largest increases were Equatorial Guinea. However, It is worth noting that there may be variations among specific subtypes of leukemia. Regions with high Socio-demographic Index (SDI) have had the highest ASR, while low-middle SDI regions have shown the greatest increase in these rates. All ASRs values have been positively correlated with SDI, but there has been a turning point in medium to high SDI regions. Leukemia attributable to high BMI risk is gradually becoming a heavier burden globally. Different subtypes of leukemia have distinct temporal and regional patterns. This study's findings will provide information for analyzing the worldwide disease burden patterns and serve as a basis for disease prevention, developing suitable strategies for the modifiable risk factor.

Aim To analyze the worldwide epidemiology of lip and oral cavity cancer attributable to smoking. Methods The worldwide epidemiology of lip and oral cavity cancer attributable to smoking and its spatial distribution differences were analyzed using the age-standardized mortality rate, age-standardized disability-adjusted life years (DALYs) rate, and estimated annual percent change (EAPC) according to information from the Global Burden of Disease Study 2019. Results The number of deaths and DALYs associated with lip and oral cavity cancer attributable to smoking globally showed upward trends from 1990 to 2019, but the age-standardized mortality and DALYs rates decreased. The age-standardized mortality rate gradually increased with age. The age-standardized mortality and DALYs rates were markedly higher in low-middle social development index (SDI) regions than in other regions. The age-standardized mortality and DALYs rates showed slight increasing trends (EAPC = 0.16 and 0.07, respectively) in middle-SDI regions and the greatest decrease (EAPC = –1.60 and –1.74, respectively) in high-SDI regions. The three regions with the highest age-standardized mortality and DALYs rates were South Asia (1.59; 39.68), Eastern Europe (1.33; 40.59), and Central Europe (1.30; 37.67), but the largest increases were observed in East Asia (EAPC = 2.32, EAPC = 2.30), the Northern Mariana Islands (EAPC = 3.79, EAPC = 3.67), and Cabo Verde (EAPC = 2.84; DALY, EAPC = 3.38). Conclusion The overall disease burden attributable to smoking is decreasing, but the number of deaths and DALYs are still increasing. Moreover, there are regional and national differences, and high-risk regions and countries should implement targeted interventions to reduce the burden.

With a rapidly growing and aging world population, ischemic heart disease (IHD) remains a major burden. This study aimed to reassess the prevalence trend of IHD from 1990 to 2021 from multiple dimensions to improve the shortcomings of the existing studies and provide a solid scientific basis for policymakers. This study extracted data on the prevalence, incidence, mortality, disability-adjusted life years (DALYs), and associated risk factors of IHD from the global burden of disease (GBD) 2021 study. Descriptive, decomposition, and risk factor analyses were used to provide insights into the epidemiologic patterns of IHD from 1990 to 2021 and project the burden of IHD from 2022 to 2045. Potential differences in burden and risk factors based on age, sex, 21 GBD geographic regions, five social development index (SDI) regions, and 204 countries are highlighted. Globally, the age-standardized prevalence rate (ASPR) of IHD is increasing, while the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (ASDR) are decreasing. ASPR, ASIR, ASMR, and ASDR were highest in the low-middle SDI regions and lowest in the high SDI regions. ASMR and ASDR were highest in Nauru and lowest in Portugal. Men had an overall heavier burden of IHD than women; the 65-69 age group had the largest burden, and those aged >95 years had the highest crude incidence rate. In addition, the burden of IHD was negatively correlated with SDI across regions and countries, while decomposition analyses suggest that the main reasons for the current increase in the burden of IHD are aging and population growth. Risk factors have changed relatively little over the 32 years, with metabolic risk still ranking first. We forecast that the absolute burden of IHD will continue to increase till 2045; however, ASIR, ASMR, and ASDR will gradually decline. From 1990 to 2021, the global burden of IHD generally increased and varied across regions, sex, and age groups. Due to increasing population growth and aging, there is an urgent need for strategically directed measures to reduce the burden of IHD.

Smoking is a well-established risk factor for kidney cancer. Analyzing the latest global spatio-temporal trends in the kidney cancer burden attributable to smoking is critical for informing effective public health policies. Using data from the 2021 GBD database, we examined deaths, disability-adjusted life years (DALYs), and age-standardized rate (ASR) of kidney cancer attributable to smoking across global, regional, and national levels. Trends in ASRs were assessed through estimated annual percentage change (EAPC). We conducted a cross-country analysis to evaluate disparities in the kidney cancer burden from 1990 to 2021, with absolute and relative inequalities measured by the slope index of inequality and concentration index, respectively. Correlation analysis was conducted by the Spearman rank order correlation method. Additionally, we projected age-standardized death and DALYs rates up to 2036 using Bayesian age-period-cohort (BAPC) models in R. Globally, kidney cancer deaths attributable to smoking increased by 67.64%, from 9,673 in 1990 to 16,216 in 2021. Despite this increase, the age-standardized death rate (ASDR) dropped from 0.25 to 0.19 per 100,000 (EAPC: -0.93). Similarly, the age-standardized disability-adjusted life years rate (ASDALY) decreased from 6.17 to 4.37 per 100,000 (EAPC: -1.15). Geographically, areas with a higher Socio-demographic Index (SDI) were the most affected. The positive correlation between higher SDI and increased deaths highlights the role of economic and social factors in disease prevalence. Cross-country analysis shows that while relative inequalities between groups are improving, absolute differences in health burdens continue to grow. Furthermore, projections indicate a gradual decline in ASDR and ASDALY for both sexes from 2022 to 2036. Between 1990 and 2021, both the global ASDR and ASDALY attributable to smoking in kidney cancer, which are positively correlated with SDI, have declined. However, significant demographic and geographic disparities persist, with the disease burden remaining higher in older populations and regions with elevated SDI levels. Moreover, while the overall burden is projected to decline annually over the next 15 years, it is expected to remain significantly higher in men. These findings emphasize the need for region-specific health prevention strategies to reduce smoking-related kidney cancer.

BackgroundPulmonary arterial hypertension (PAH) is a severe and progressive lung disease that significantly impairs patients’ health and imposes heavy clinical and economic burdens. Currently, there is a lack of comprehensive epidemiological analysis on the global burden and trends of PAH.MethodsWe estimated the prevalence, mortality, disability-adjusted life years (DALYs) of PAH from 1990 to 2021 using the results of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). The average annual percentage changes were used to estimate the trends of PAH across 21 regions and 204 countries and territories.ResultsFrom 1990 to 2021, the number of prevalent cases and deaths associated with PAH worldwide increased by 81.5 and 48.4%. However, the age-standardized prevalence rate of PAH remained relatively stable, while the age-standardized mortality rate and DALYs declined. In 2021, the global age-standardized prevalence rate of PAH was 2.28 per 100,000, with 1.78 per 100,000 in males and 2.75 per 100,000 in females. The age-standardized mortality rate of PAH globally was 0.27 per 100,000, and the age-standardized DALYs was 8.24 per 100,000. Among the 21 regions, Western Europe had the highest age-standardized prevalence rate (3.56 per 100,000), while North Africa and the Middle East had the highest age-standardized mortality rate (0.44 per 100,000) and DALYs (14.81 per 100,000). Additionally, older individuals and females are at higher risk of PAH. The age-standardized mortality rate and DALYs associated with PAH increase with age, peaking in the 95+ age group. As the sociodemographic index increased, the age-standardized prevalence rates showed an upward trend, while both the age-standardized mortality rates and DALYs exhibited a downward trend.ConclusionFrom 1990 to 2021, the overall trend of PAH burden presents regional and national variations and differs by age, sex, and sociodemographic index. These findings emphasize the importance of implementing targeted interventions to alleviate the burden of PAH.

Understanding the current burden of stomach cancer linked to smoking and the variations in trends across different locations, is crucial for developing effective prevention strategies. In this study, we present findings on the age-standardized death rate (ASDR) and age-standardized disability-adjusted life years (DALYs) rate attributed to smoking in 204 countries and territories spanning 21 regions from 1990 to 2019. The data for this study were obtained from the Global Burden of Disease Study (GBD) 2019, which assessed 369 diseases and injuries, as well as 87 risk factors in 204 countries and 21 regions. To assess the trend in ASDR and age-standardized DALYs rate, the estimated annual percentage change (EAPC) was utilized. Between 1990 and 2019, smoking was found to be associated with a decrease in ASDR (EAPC = -2.20) and age-standardized DALYs (EAPC = -2.42) rates for gastric cancer. As the sociodemographic index (SDI) increased, the decline in rates also increased gradually. However, the decline was smallest in regions with low SDI (EAPCASDR = -1.34; EAPCage-standardized DALYs rate = -1.38). In 21 regions, both ASDR and DALYs rates experienced a decline. The smallest decline in ASDR was observed in Western Sub-Saharan Africa, with an EAPC of -0.80, while the smallest decline in DALYs rate was found in Oceania, with an EAPC of -0.81. Among the 204 countries analyzed, the Dominican Republic showed the highest increase in ASDR and age-standardized DALYs rate (EAPCASDR = 1.19; EAPCage-standardized DALYs rate = 1.21), followed by Afghanistan (EAPCASDR = 1.09; EAPCage-standardized DALYs rate = 1.09) and Sao Tome and Principe (EAPCASDR = 1.05; EAPCage-standardized DALYs rate = 1.03). In the year 2019, the highest ASDR and age-standardized DALYs rate was observed in East Asia, with the highest rates occurring in Mongolia. The burden of stomach cancer worldwide, adjusted for age, and related to smoking, has shown a decline from 1990 to 2019. However, regional disparities have been identified, with some areas experiencing an increase in this burden. These regions with a higher burden emphasize the necessity for the implementation of strong tobacco control measures.

Introduction The burden of ischaemic heart disease (IHD) has declined in several countries, although IHD remains the leading cause of death globally. Brazil is a large country with high inequality in income distribution across different regions. Purpose This study sought to evaluate the burden of IHD in Brazil from 1990 to 2019, as well as the relationship between temporal changes and socioeconomic level of the Federative Units. Methods Estimates of prevalence, mortality, and disability-adjusted life-years (DALYs) due to IHD were retrieved from the Global Burden of Disease Study 2019. We used databases from the Ministry of Health of Brazil to obtain the number of hospitalisations from acute coronary syndrome (ACS) and acute myocardial infarction (AMI) in the context of the public service. The Socio-demographic Index (SDI), a composite indicator of income per capita, average educational attainment, and fertility rate in females younger than 25 years, was used as a measure of socioeconomic status. Rates with 95% uncertainty intervals are reported. Results In 2019, the age-standardised prevalence rate of IHD was 1,709 (1,466–1,994) per 100,000 inhabitants. This rate remained stable from 1990 to 2019 (percent change: −1.1 [−2.6–0.5]). The estimate of deaths from IHD in 2019 was 171,246 (156,180–180,511), corresponding to 12% (11%-13%) of total deaths in the country (the leading cause) and 43% of all cardiovascular deaths. In 2019, the age-standardised mortality rate due to IHD was 75 (68–79) per 100,000. The unadjusted mortality rate due to IHD mildly increased from 2005 to 2019, while the age-standardised rate continuously decreased from 1990 to 2019 (cumulative percent change: −53 (−55 to −50, Figure 1). A negative correlation was observed between the change in age-standardised mortality rate from IHD in the period and the 2019 SDI (Figure 2). In 2019, the age-standardised DALY rate due to IHD was 1,563 (1,472–1,636) per 100,000. This DALY rate was equivalent to 5.7% (5.1%-6.3%) of total DALYs, meaning that IHD was the second most common cause of DALYs in Brazil in females and males. From 1990 to 2019, the crude DALY rate per 100,000 remained fairly stable, and the age- standardised DALY rate per 100,000 gradually declined (−50% [−52% to −48%]). There was a negative correlation between the change in age-standardised DALY rate from IHD in the period and the SDI (r2 0.59, p-value <0.01). The number of hospital admissions for ACS remained stable from 2008 to 2019 (33 per 100,000 in 2019). The number of hospitalisations due to AMI increased from 25 per 100,000 in 2008 to 39 per 100,000 in 2019 (percent change: 52%). Conclusions While age-standardised mortality, DALY rates continuously decreased from 1990 to 2019, the burden of IHD in Brazil remains high, probably due to ageing and population growth. Reductions in age-standardised mortality, DALY rates over time tend to be more pronounced in more developed regions. Funding Acknowledgement Type of funding sources: None. Mortality rate (per 100,000)Change in mortality rate and SDI

To report the prevalence, deaths, and disability-adjusted life years (DALYs) associated with ischemic heart disease (IHD) and its attributable risk factors in 204 countries and territories from 1990 to 2019, by age, sex, and socio-demographic index (SDI). Ischemic heart disease was defined as acute myocardial infarction (MI) and chronic IHD (angina; asymptomatic IHD following MI). Cause of death ensemble modelling was used to produce fatality estimates. The prevalence of the non-fatal sequalae of IHD was estimated using DisMod MR 2.1. All estimates were presented as counts and age-standardized rates per 100000 population. In 2019, IHD accounted for 197.2 million (177.7-219.5) prevalent cases, 9.1 million (8.4-9.7) deaths, and 182.0 million (170.2-193.5) DALYs worldwide. There were decreases in the global age-standardized prevalence rates of IHD [-4.6% (-5.7, -3.6)], deaths [-30.8% (-34.8, -27.2)], and DALYs [-28.6% (-33.3, -24.2)] from 1990 to 2019. In 2019, the global prevalence and death rates of IHD were higher among males across all age groups, while the death rate peaked in the oldest group for both sexes. A negative association was found between the age-standardized DALY rates and SDI. Globally, high systolic blood pressure (54.6%), high low-density lipoprotein cholesterol (46.6%), and smoking (23.9%) were the three largest contributors to the DALYs attributable to IHD. Although the global age-standardized prevalence, death, and DALY rates all decreased. Prevention and control programmes should be implemented to reduce population exposure to risk factors, reduce the risk of IHD in high-risk populations, and provide appropriate care for communities.

Global, regional, and national burden of ischemic heart disease attributable to ambient PM2.5 from 1990 to 2019: An analysis for the global burden of disease study 2019

In the context of the population growing and aging worldwide, the incidence of non-rheumatic valvular heart disease increased rapidly. This study aimed to describe the burden of non-rheumatic valvular heart disease, providing an up-to-date and comprehensive analysis on the global and regional levels and time trends from 1900 to 2019. The Global Burden of Disease 2019 was used to obtain data for this analysis. Non-rheumatic valvular heart disease in the Global Burden of Disease study includes both non-rheumatic calcific aortic valve disease and non-rheumatic degenerative mitral valve disease. The incidence, mortality, and disability-adjusted life year in 204 countries from 1990 to 2019 were analyzed by location, year, sex, age, and socio-demographic index. Estimated annual percentage change was calculated to represent the temporal trends from 1990 to 2019. Spearman's rank order correlation was used to determine the correlation between socio-demographic index and the incidence and burden of non-rheumatic valvular heart disease. Globally, there were 1.65 million (95% uncertainty interval, 1.56-1.76 million) incident cases, 0.16 million (95% uncertainty interval, 0.14-0.18 million) death cases, and 2.79 million (95% uncertainty interval, 2.52-3.31 million) disability-adjusted life years of non-rheumatic valvular heart disease. Compared with 1990, the number of incident cases, death cases, and disability-adjusted life years in 2019 increased by 104.58%, 210.60%, and 167.62%, respectively, the age-standardized incidence rate (estimated annual percentage change, 0.39; 95% confidence interval, 0.29 to 0.49) increased due to population growth, and the age-standardized death rates (estimated annual percentage change, -0.32; 95% confidence interval, -0.39 to -0.25) and age-standardized disability-adjusted life year rate (estimated annual percentage change, -0.81; 95% confidence interval, -0.87 to -0.74) decreased during this period. Regarding the socio-demographic index, the highest age-standardized incidence, death, and disability-adjusted life year rates of non-rheumatic valvular heart disease were found in high-socio-demographic index countries in 2019. Meantime, the age-standardized incidence rate remained increased from 1990 to 2019, while significant decreases were found in the age-standardized death rate and age-standardized disability-adjusted life year rate. Females have higher age-standardized incidence rate, while higher age-standardized death rate and age-standardized disability-adjusted life year rate belong to males globally during the period of 1990-2019. Increasing trends were observed for both incidence, death, and disability-adjusted life year rates with age. High systolic blood pressure was the leading cause for non-rheumatic valvular heart disease across all ages. From 1990 to 2019, the age-standardized incidence rate of non-rheumatic valvular heart disease remained increased, while age-standardized death rate and age-standardized disability-adjusted life year rate decreased, resulting from the growing population worldwide and improving medical resources. The aged, who has high systolic blood pressure and diet high in sodium, should pay more attention to, especially in high-socio-demographic index regions. With the population aging, the number of patients who require heart valve replacement is estimated to increase significantly in the future. Effective measures are warranted to control and treat the incidence and burden of non-rheumatic valvular heart disease.

Based on data from the Global Burden of Disease study, the burden of cancer attributable to occupational risks between 1990 and 2019 was explored. The estimated burden in different regions was compared in terms of the age-standardized death rates (ASDRs), age-standardized disability-adjusted life years (DALYs) rates, and corresponding estimated annual percentage changes (EAPCs). The comparative risk assessment framework was used to estimate the risk of death and DALYs attributable to occupational risk factors. Globally from 1990 to 2019, ASDRs decreased (EAPC = -0.69; 95% CI: -0.76 to -0.61), and age-standardized DALY rates decreased (EAPC = -0.99; 95% CI: -1.05 to -0.94). In terms of the global age distribution of cancer attributable to occupational risk factors, the death rate and DALY rates increased with age. In addition, from 1990 to 2019, the number of deaths, DALYs, ASDRs, and age-standardized DALY rates in men were higher than those in women, and the cancer burden grew fastest in Georgia (EAPC = 5.04), Croatia (EAPC = 4.01), and Honduras (EAPC = 3.54). Moreover, as the sociodemographic index (SDI) value of a country or region increased, its burden of cancer attributable to occupational risk factors rapidly increased. The global cancer burden attributable to occupational risk factors declined from 1990 to 2019, was higher in men than in women, and was concentrated in middle-aged and older adults. The baseline cancer burdens of regions or countries increased as their SDI values increased and were especially high in high-SDI regions or countries.

BackgroundGlobally, the issue of ischaemic heart disease (IHD) has emerged as a prominent public health challenge in the ongoing process of ageing. Previous assessments relied upon data constrained by geographical scope and lacking a thorough worldwide evaluation. We aimed to present the incidence, prevalence, death, and disability-adjusted life years (DALYs) due to IHD at global, regional, and national levels from 1990 to 2021, emphasising decomposition and progressive analysis. We aim to provide relevant information to guide health policy decisions, allocate medical resources effectively, and improve patient care protocols for greater efficiency.MethodsWe aimed to accurately depict the health impact of IHD by applying standardised Global Burden of Disease approaches and analysing four key epidemiological indicators: prevalence, incidence, mortality, and DALYs. We quantified temporal trends in the burden of IHD from 1990 to 2021 using the estimated annual percentage change (EAPC) metric. We conducted an in-depth examination of global trends, categorising them by age group, gender, and the sociodemographic index (SDI) to provide a more nuanced understanding. Decomposition analyses of IHD DALYs, which examine the effects of age distribution, population dynamics, and changes in disease patterns, enabled us to accurately quantify the specific contributions of each factor to the overall IHD burden. Using frontier analytical methods, we intended to pinpoint the minimal plausible burden of IHD, contingent on the level of development, as gauged by the SDI.ResultsIn 2021, the age-standardised incidence rate (ASIR) of IHD decreased compared with 1990 (EAPC = −0.44; 95% confidence interval = −0.47, −0.42). Moreover, the age-standardised mortality rates (ASMR) and DALYs (ASDR) decreased over time. The overall IHD burden was marginally higher in males than in females. The global rates for prevalence, incidence, deaths, and DALYs related to IHD demonstrated an overall rising trend along with age. Among all regions, the North Africa and Middle East region exhibited the highest ASIR (ASIR = 895.85; 95% uncertainty interval (UI) = 786.65, 1043.49) and age-standardised prevalence rate (ASPR) (ASPR = 6404.84; 95% UI = 5872.02, 7041.08) for IHD in 2021. Central Asia recorded the highest ASMR (ASMR = 265.51; 95% UI = 240.67, 290.42) and ASDR (ASDR = 4864.49; 95% UI = 4415.55, 5338.75) in 2021. Decomposition analysis revealed population growth and ageing as primary factors driving the rise in IHD DALYs. Frontier analysis illuminated ample room for enhancement across the entire development continuum.ConclusionsThe variability in IHD burden is influenced by gender, age, and geographic location. The global burden of IHD has persistently increased during the last three decades, notably among older males. The escalating ageing population and demographic expansion underscore the importance of bolstering public health measures and optimising resource allocation, particularly in etiological investigation, prompt diagnosis, preventive measures, and locally tailored management for IHD.