Secular Trends in the Epidemiologic Patterns of Peripheral Artery Disease and Risk Factors in China from 1990 to 2019: Findings from the Global Burden of Disease Study 2019

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2022 Oct 7

PMID 36204576

Authors

Wei Gong

Shuhan Shen

Xiaojing Shi

Affiliations

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Abstract

Background: An understanding of the epidemiologic patterns of peripheral artery disease is essential in public health policy-making. We aimed to assess secular trends in the epidemiologic patterns and risk factors of peripheral artery disease from 1990 to 2019 in China.

Materials And Methods: We extracted data on prevalence, incidence, death, and disability-adjusted life years (DALYs) due to peripheral artery disease from the Global Burden of Disease study 2019. In addition, risk factors for peripheral artery disease were reported.

Results: The age-standardized prevalence of peripheral artery disease significantly increased from 1330.42 to 1423.78 per 100,000 population, with an average annual percentage change (AAPC) of 0.16 [95% confidence interval (CI), 0.07 to 0.24] from 1990 to 2019 in China. In addition, the age-standardized mortality rate significantly increased, with an AAPC of 0.62 (95% CI, 0.54 to 0.7), contrasting with the significantly declining trend in age-standardized DALYs (AAPC, -0.45; 95% CI, -0.52 to -0.39) between 1990 and 2019. The age-standardized prevalence was almost three times higher in females than males [2022.13 (95% CI: 1750 to 2309.13) vs. 744.96 (95% CI: 644.62 to 850.82) per 100,000 population] in 2019. The age-specific incidence significantly increased in individuals aged 40-44, 45-49, 50-54, 55-59, and 60-64 years groups but decreased in 70-74, 75-79, and 80-84 years groups. The age and period effects showed that the relative risks of incident peripheral artery disease increased with age and time. The cohort assessment showed that the incidence decreased in successive birth cohorts. Smoking was identified as the risk factor that contributed the most to age-standardized DALYs of peripheral artery disease in 2019.

Conclusion: The burden of peripheral artery disease showed unexpected patterns that varied by age, sex, and year in China. More attention should be given to addressing the increasing incidence among middle-aged individuals and mortality among males.

References

Li R, Cheng X, Schwebel D, Yang Y, Ning P, Cheng P . Disability-adjusted life years associated with population ageing in China, 1990-2017. BMC Geriatr. 2021; 21(1):369. PMC: 8207592. DOI: 10.1186/s12877-021-02322-7. View

Guan H, Li Y, Xu Z, Li G, Guo X, Liu Z . Prevalence and risk factors of peripheral arterial disease in diabetic patients over 50 years old in China. Chin Med Sci J. 2007; 22(2):83-8. View

Huang Y, Xu M, Xie L, Wang T, Huang X, Lv X . Obesity and peripheral arterial disease: A Mendelian Randomization analysis. Atherosclerosis. 2016; 247:218-24. DOI: 10.1016/j.atherosclerosis.2015.12.034. View

Li Y, Guo C, Cao Y . Secular incidence trends and effect of population aging on mortality due to type 1 and type 2 diabetes mellitus in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019. BMJ Open Diabetes Res Care. 2021; 9(2). PMC: 8572387. DOI: 10.1136/bmjdrc-2021-002529. View

Kroger K, Dragano N, Stang A, Moebus S, Mohlenkamp S, Mann K . An unequal social distribution of peripheral arterial disease and the possible explanations: results from a population-based study. Vasc Med. 2009; 14(4):289-96. DOI: 10.1177/1358863X09102294. View

Clayton D, Schifflers E . Models for temporal variation in cancer rates. II: Age-period-cohort models. Stat Med. 1987; 6(4):469-81. DOI: 10.1002/sim.4780060406. View

Bridgwood B, Nickinson A, Houghton J, Pepper C, Sayers R . Knowledge of peripheral artery disease: What do the public, healthcare practitioners, and trainees know?. Vasc Med. 2020; 25(3):263-273. DOI: 10.1177/1358863X19893003. View

Fowkes F, Rudan D, Rudan I, Aboyans V, Denenberg J, McDermott M . Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013; 382(9901):1329-40. DOI: 10.1016/S0140-6736(13)61249-0. View

Belch J, Topol E, Agnelli G, Bertrand M, Califf R, Clement D . Critical issues in peripheral arterial disease detection and management: a call to action. Arch Intern Med. 2003; 163(8):884-92. DOI: 10.1001/archinte.163.8.884. View

10.

Criqui M, Aboyans V . Epidemiology of peripheral artery disease. Circ Res. 2015; 116(9):1509-26. DOI: 10.1161/CIRCRESAHA.116.303849. View

11.

Li Y, Teng D, Shi X, Teng X, Teng W, Shan Z . Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: two national cross-sectional surveys. Lancet Reg Health West Pac. 2021; 15:100227. PMC: 8342963. DOI: 10.1016/j.lanwpc.2021.100227. View

12.

Clegg L, Hankey B, Tiwari R, Feuer E, Edwards B . Estimating average annual per cent change in trend analysis. Stat Med. 2009; 28(29):3670-82. PMC: 2843083. DOI: 10.1002/sim.3733. View

13.

. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1204-1222. PMC: 7567026. DOI: 10.1016/S0140-6736(20)30925-9. View

14.

Agnelli G, Belch J, Baumgartner I, Giovas P, Hoffmann U . Morbidity and mortality associated with atherosclerotic peripheral artery disease: A systematic review. Atherosclerosis. 2019; 293:94-100. DOI: 10.1016/j.atherosclerosis.2019.09.012. View

15.

He Y, Jiang Y, Wang J, Fan L, Li X, Hu F . Prevalence of peripheral arterial disease and its association with smoking in a population-based study in Beijing, China. J Vasc Surg. 2006; 44(2):333-8. DOI: 10.1016/j.jvs.2006.03.032. View

16.

Pabon M, Cheng S, Altin S, Sethi S, Nelson M, Moreau K . Sex Differences in Peripheral Artery Disease. Circ Res. 2022; 130(4):496-511. PMC: 8919803. DOI: 10.1161/CIRCRESAHA.121.320702. View

17.

Song P, Rudan D, Zhu Y, Fowkes F, Rahimi K, Fowkes F . Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health. 2019; 7(8):e1020-e1030. DOI: 10.1016/S2214-109X(19)30255-4. View

18.

Yang G, Ma J, Liu N, Zhou L . [Smoking and passive smoking in Chinese, 2002]. Zhonghua Liu Xing Bing Xue Za Zhi. 2005; 26(2):77-83. View

19.

. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1223-1249. PMC: 7566194. DOI: 10.1016/S0140-6736(20)30752-2. View

20.

Wang M, Luo X, Xu S, Liu W, Ding F, Zhang X . Trends in smoking prevalence and implication for chronic diseases in China: serial national cross-sectional surveys from 2003 to 2013. Lancet Respir Med. 2018; 7(1):35-45. DOI: 10.1016/S2213-2600(18)30432-6. View