Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories

Penghong Deng; Yu Fu; Mingsheng Chen; Dong Wang; Lei Si

doi:10.1186/s12939-023-01988-2

Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories

Penghong Deng, Yu Fu, Mingsheng Chen, Dong Wang, Lei Si

Western Sydney University

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population’s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019. Methods: We extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019. Results: The age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease. Conclusions: Globally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.

Original language	English
Article number	164
Number of pages	13
Journal	International Journal for Equity in Health
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12939-023-01988-2
Publication status	Published - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.

Open Access - Access Right Statement

Â© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12939-023-01988-2

Cite this

@article{611cadb9961849e28b1b26a9f6e164aa,

title = "Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories",

abstract = "Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population{\textquoteright}s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019. Methods: We extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019. Results: The age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease. Conclusions: Globally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.",

author = "Penghong Deng and Yu Fu and Mingsheng Chen and Dong Wang and Lei Si",

note = "Publisher Copyright: {\textcopyright} 2023, BioMed Central Ltd., part of Springer Nature.",

year = "2023",

month = dec,

doi = "10.1186/s12939-023-01988-2",

language = "English",

volume = "22",

journal = "International Journal for Equity in Health",

issn = "1475-9276",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories

AU - Deng, Penghong

AU - Fu, Yu

AU - Chen, Mingsheng

AU - Wang, Dong

AU - Si, Lei

PY - 2023/12

Y1 - 2023/12

N2 - Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population’s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019. Methods: We extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019. Results: The age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease. Conclusions: Globally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.

AB - Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population’s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019. Methods: We extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019. Results: The age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease. Conclusions: Globally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.

UR - https://hdl.handle.net/1959.7/uws:71936

U2 - 10.1186/s12939-023-01988-2

DO - 10.1186/s12939-023-01988-2

M3 - Article

SN - 1475-9276

VL - 22

JO - International Journal for Equity in Health

JF - International Journal for Equity in Health

IS - 1

M1 - 164

ER -

Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories

Abstract

Bibliographical note

Open Access - Access Right Statement

UN SDGs

Access to Document

Other files and links

Fingerprint