The impact and evolution of environmental/occupational, behavioural, and metabolic risk factors on CVD burdens in the Asia-Pacific region from 1990 to 2023: a secondary analysis of the Global Burden of Disease Study 2023.
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Chew Nicholas W S, Chen Yiming, Cader F Aaysha, Chong Bryan, Chow Clara K, Grey Corina, Guo Yuming, Himan Haryo Raden, Jayabaskaran Jayanth, Matthias Thushara, Nagarajan Srinithy, Nelson Adam J, Ng Marie, Rejack Georgia, Rolleston Anna, Roth Gregory, Roy Ambuj, Sasikumar Navaneetha, Sawano Mitsuaki, Tan Kathryn Choon Beng, Tromp Jasper, Yan Lijing L, Yeo Khung Keong, Nicholls Stephen J, Lam Carolyn S P, Lancet Commission on Tackling Cardiovascular Disease in the Asia Pacific Regionac, Lancet Commission on Tackling Cardiovascular Disease in the Asia Pacific Region
Аннотация
METHODS: Estimates from the Global Burden of Disease Study 2023 were used to quantify cardiovascular mortality and disability-adjusted life years (DALYs) attributable to environmental/occupational, behavioural, and metabolic risk factors across 39 Asia-Pacific countries.
FINDINGS: In 2023, cardiovascular risk factors contributed to 197.1 million DALYs, with an age-standardised DALY rate of 4463.7 per 100,000 population in the Asia-Pacific, which is 16.4% higher than the global estimate. Between 1990 and 2023, age-standardised DALYs declined by 34.9%, yet crude risk-attributable DALYs rose by 61.5%, as the demographic forces of population ageing (87.3%) and growth (45.3%) overwhelmed the gains from risk exposure reduction (-71.1%). Among risk factor categories, metabolic risk factors contributed to the fastest rise in CVD morbidity (74.3%), followed by behavioural (49.5%), and environmental/occupational risk factors (44.6%). The leading risk factors were high systolic blood pressure, dietary risks, air pollution and high LDL cholesterol.
INTERPRETATION: The improvements in cardiovascular risk factor exposure in the Asia-Pacific have been offset by population growth and ageing. The metabolic-centric pattern in risk factors demands for strategies in tackling the region's high priority metabolic risk factor targets.
FUNDING: SingHealth Duke-National University of Singapore Cardiovascular Sciences Academic Clinical Programme, the National Medical Research Council of Singapore, and the Stafford Fox Foundation.