Global, Regional, and National Burden of Ischemic Heart Disease Attributable to 25 Risk Factors and Their Summary Exposure Value Across 204 Countries With Different Socio-Demographic Index Levels, 1990-2021: A Systematic Fixed-Effects Analysis and Comparative Study

Background

A systematic relational assessment of the global, regional, and national Ischemic heart disease (IHD) burden and its attributable risk factors is essential for developing more targeted prevention and intervention strategies.

Methods

The GBD 2021 comparative risk assessment framework was employed to evaluate stroke burden attributable to environmental, behavioral, metabolic, and dietary risk factors, and a total of 25 risk factors were included. Specifically, we used the joinpoint regression model, decomposition analysis, and systematic fixed-effects analysis to reveal the global, regional, and national burden of IHD attributable to these 25 risk factors and their exposure value across 204 countries and territories with different socio-demographic index (SDI) levels from different perspectives.

Results

Joinpoint regression revealed similar trends in summary exposure value (SEV) and attributable burdens for 25 IHD risk factors. From 1990 to 2021, SEV rankings increased for 12/25 risk factors, decreased for 10/25, and remained unchanged for 3/25. Decomposition analysis indicated that from 1990 to 2021, low SDI countries experienced the most significant increase in IHD burden attributable to 25 risk factors due to population growth, while upper-middle and high SDI countries were most affected by population aging, and high SDI countries demonstrated the greatest reduction in IHD burden attributed to epidemiological changes. Panel data analysis elucidated the impact of SEV, SDI, and quality-of-care index (QCI) on attributable IHD burden.

Conclusion

This study emphasizing the critical role of risk factor control. Tailored interventions and exploration of country-specific factors are crucial for effectively reducing the global IHD burden.

Global, Regional, and National Quality of Care Index (QCI) of Gastric Cancer: A Systematic Analysis for the Global Burden of Disease Study 1990-2017

BACKGROUND

Gastric Cancer (GC)is the third leading cause of cancer death worldwide. We aimed to compare the quality of care of GC at global, regional, and national levels from 1990 to 2017 in different age, sex, and socio-demographic groups using the quality-of-care index.

MATERIAL

METHOD: We used Mortality to Incidence Ratio, DALY to Prevalence Ratio, YLL to YLD Ratio, and Prevalence to Incidence Ratio, that all indicate the quality of care. Then, using Principal Component Analysis (PCA), these values are combined. A new index called QCI (Quality of Care Index), which indicates quality, is introduced to compare the quality of care in different countries in 1990 and 2017. Scores were calculated and scaled 0-100, with higher scores indicating better status.

RESULTS

The global QCI of GC in 1990 and 2017 was 35.7 and 66.7, respectively. The QCI index is 89.6 and 16.4 in high and low SDI countries, respectively. In 2017, Japan had the highest QCI with a 100 score. Japan was followed by South Korea, Singapore, Australia, and the United States with 99.5, 98.4, 98.3, and 90.0. On the other hand, the Central African Republic, Eritrea, Papua New Guinea, Lesotho, and Afghanistan with 11.6, 13.0, 13.1, 13.5, and 13.7 had the worst QCI, respectively.

CONCLUSION

The quality of care of GC has increased worldwide from 1990 to 2017. Also, higher SDI was associated with more quality of care. We recommend conducting more screening and therapeutic programs for early detection and to improve gastric cancer treatment in developing countries.

Particulate Matter Pollution Remains a Threat for Cardiovascular Health: Findings From the Global Burden of Disease 2019

Background Particulate matter (PM) pollution is a significant risk factor for cardiovascular diseases, causing substantial disease burden and deaths worldwide. This study aimed to investigate the global burden of cardiovascular diseases attributed to PM from 1990 to 2019. Methods and Results We used the GBD (Global Burden of Disease) study 2019 to investigate disability-adjusted life-years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to PM as well as its subgroups. It was shown that all burden measures' age-standardized rates for PM were in the same decreasing trend, with the highest decline recorded for deaths (-36.7%). However, the all-age DALYs increased by 31%, reaching 8.9 million in 2019, to which YLLs contributed the most (8.2 million [95% uncertainty interval, 7.3 million-9.2 million]). Men had higher deaths, DALYs, and YLLs despite lower years lived with disability in 2019 compared with women. There was an 8.1% increase in the age-standardized rate of DALYs for ambient PM; however, household air pollution from solid fuels decreased by 65.4% in the assessed period. Although higher in men, the low and high sociodemographic index regions had the highest and lowest attributed YLLs/YLDs ratio for PM pollution in 2019, respectively. Conclusions Although the total age-standardized rate of DALYs for PM-attributed cardiovascular diseases diminished from 1990 to 2019, the global burden of PM on cardiovascular diseases has increased. The differences between men and women and between regions have clinical and policy implications in global health planning toward more exact funding and resource allocation, in addition to addressing inequity in health care access.

Level and trend of total plasma cholesterol in national and subnational of Iran: a systematic review and age-spatio-temporal analysis from 1990 to 2016

Purpose

We aimed to estimate the level and trend of plasma cholesterol and raised total cholesterol (TC > 200 mg/dl) prevalence at national and subnational level of Iran.

Methods

Nine national surveys and 27 studies, encompassing 3,505 unique points on over 500,000 adults, aged > 25 years with a report of laboratory measurement of TC were found. Age-spatio-temporal model and Gaussian Process Regression were used to estimate mean TC for each sex, 5-year age groups, and 31 provinces from 1990 to 2016.

Results

At national level, age-standardized prevalence of TC > 200 mg/dL has decreased from 57·2%(53·3-61·1) to 22·4%(20·5-24·3) in women and 53·2%(49·1-57·3) to 18·0%(16·4-19·6) in men. TC distribution presented a condensation between 170-200 mg/dL. At subnational level, decreasing and converging patterns of raised TC prevalence were detected.

Conclusion

The decrease in raised TC is likely the result of statin widespread use, food industry improvements, and the expanded primary health care.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-022-01052-w.