[Study of changing trends, risk factors and prediction of disease burden of three acquired heart diseases in China, 1990-2023].

Objective: To analyze the characteristics of disease burden and risk factors of acquired heart diseases in China from 1990 to 2023, predict their trends from 2024 to 2050, and provide data support for the development of prevention and control policies. Methods: Based on the Global Burden of Disease Study, we collected disability-adjusted life year (DALY) data of three types of acquired heart diseases (rheumatic heart disease, hypertensive heart disease, and ischemic heart disease) in China from 1990 to 2023. Joinpoint regression model was used to estimate the average annual percentage change (AAPC) to describe temporal trends. A Bayesian age-period-cohort model was applied to predict the trends from 2024 to 2050. Results: From 1990 to 2023, the age-standardized DALY rates (ASDRs) of the three types of acquired heart diseases in China all exhibited decreasing trends, the AAPCs for rheumatic heart disease, hypertensive heart disease and ischemic heart disease were -6.6%, -3.7% and -0.8%, respectively (all P<0.001). The age group with the highest DALY rate for all the three diseases was ≥80 years, while the lowest was under 20 years. The DALY rates of rheumatic heart disease and hypertensive heart disease declined in all the age groups. For ischemic heart disease, DALY rates decreased in all the age groups except age group ≥80 years. From 2024 to 2050, the ASDRs of rheumatic heart disease and ischemic heart disease are predicted to decline in both men and women. In contrast, the ASDR of hypertensive heart disease is predicted to decline in men but rise in women. In 2023, the top three risk factors for the disease burden of hypertensive heart disease were high systolic blood pressure, high body mass index and high sodium intake. For ischemic heart disease, the top three risk factors were high systolic blood pressure, lead exposure and high LDL-C in China. Conclusions: From 1990 to 2023, the ASDRs of three acquired heart diseases in China all showed declining trends. Predictions for 2024-2050 indicate that, with the exception of hypertensive heart disease ASDR declining in men but rising in women, the ASDRs of other two diseases would continue to decline. Acquired heart disease remains a public health problem to which sustained attention needs to be paid. Targeted prevention and control efforts should focus on modifiable risk factors, with particular emphasis on high systolic blood pressure, high body mass index, and lead exposure.