Nutrition, metabolism, and cardiovascular diseases : NMCD · 2025
Global assessment of atherosclerotic cardiovascular disease quality of care index in adults aged ≥60 years.
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Hu Ben, Li Jiaxin, Su Huimin, Wu Jun, Gao Yunfei, Yang Han, Hu Hao, Ma Likun
Аннотация
AIMS: Atherosclerotic cardiovascular disease (ASCVD) remains the primary global cause of mortality and disability. Older adults (≥60 years) represent a vulnerable population with elevated cardiovascular risk, establishing ASCVD quality of care (QoC) as a critical global health priority. This study aimed to investigate temporal trends in the global ASCVD QoC for adults aged ≥60 years.
METHODS AND RESULTS: This analysis utilized Global Burden of Disease 2021 data across 204 countries and territories. The age-standardized quality of care index (QCI) assessed ASCVD management, with concentration indices and estimated annual percentage change (EAPC) quantifying inequalities and trends. From 1990 to 2021, global QCI for ischemic heart disease (IHD), ischemic stroke (IS), and peripheral artery disease (PAD) increased from 68.65, 63.73, 85.26 to 79.83, 75.34, 88.06. Gender disparity ratios (GDR) of QCI revealed divergent trends: IHD GDR decreased (1.10-1.08), IS GDR increased (1.11-1.12), and PAD GDR remained stable (1.00). Pronounced socio-demographic index (SDI) gradients emerged. High/high-middle SDI regions demonstrated substantially faster QCI growth for IHD/IS, while lower SDI regions showed markedly slower improvement. For PAD, high-middle SDI regions achieved the most rapid QCI gains, whereas low-middle/low SDI regions experienced declines.
CONCLUSIONS: Global ASCVD QCI improvements occurred among older adults over the past three decades. However, significant disparities persist across geographic regions, SDI strata, and gender groups. These findings necessitate targeted interventions and inform policy strategies to accelerate progress toward sustainable development goals.
METHODS AND RESULTS: This analysis utilized Global Burden of Disease 2021 data across 204 countries and territories. The age-standardized quality of care index (QCI) assessed ASCVD management, with concentration indices and estimated annual percentage change (EAPC) quantifying inequalities and trends. From 1990 to 2021, global QCI for ischemic heart disease (IHD), ischemic stroke (IS), and peripheral artery disease (PAD) increased from 68.65, 63.73, 85.26 to 79.83, 75.34, 88.06. Gender disparity ratios (GDR) of QCI revealed divergent trends: IHD GDR decreased (1.10-1.08), IS GDR increased (1.11-1.12), and PAD GDR remained stable (1.00). Pronounced socio-demographic index (SDI) gradients emerged. High/high-middle SDI regions demonstrated substantially faster QCI growth for IHD/IS, while lower SDI regions showed markedly slower improvement. For PAD, high-middle SDI regions achieved the most rapid QCI gains, whereas low-middle/low SDI regions experienced declines.
CONCLUSIONS: Global ASCVD QCI improvements occurred among older adults over the past three decades. However, significant disparities persist across geographic regions, SDI strata, and gender groups. These findings necessitate targeted interventions and inform policy strategies to accelerate progress toward sustainable development goals.