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2019 年全球疾病负担研究:1990 年至 2019 年归因于环境 PM 污染的心血管疾病负担:系统分析。

Cardiovascular diseases burden attributable to ambient PM pollution from 1990 to 2019: A systematic analysis for the global burden of disease study 2019.

机构信息

Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China.

Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China.

出版信息

Environ Res. 2024 Jan 15;241:117678. doi: 10.1016/j.envres.2023.117678. Epub 2023 Nov 19.

Abstract

BACKGROUND

Ambient PM pollution (APMP) was the leading environmental risk factor for cardiovascular diseases (CVDs) worldwide. An up-to-date comprehensive study is needed to provide global epidemiological patterns.

METHODS

Detailed data on CVDs burden attributable to APMP were obtained from the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percentage change (EAPC) to assess temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years.

RESULTS

Globally, CVDs attributable to APMP resulted in 2.48 million deaths and 60.91 million DALYs, with an increase of 122%, respectively from 1990 to 2019. In general, men suffered markedly higher burden than women, but the gap will likely turn narrow. As for age distribution, CVDs deaths and DALYs attributable to APMP mainly occurred in the elder group (>70 years). Low- and middle-income regions endured the higher CVDs burden due to the higher exposure to APMP, and the gap may potentially expand further compared with high-income regions. For regions, the highest age-standardized rates of APMP-related CVDs deaths and DALYs were observed mainly in Central Asia, while the lowest was observed in Australasia. At the national level, countries with the largest ASDR decline were clustered in western Europe, while Equatorial Guinea, Timor-Leste and Bhutan exhibited relatively rapid increases over this period.

CONCLUSIONS

The global CVDs burden attributable to APMP has contributed to the heterogeneity of spatial and temporal distribution. APMP-related CVDs deaths have largely shifted from higher SDI regions to those with a lower SDI. Globally, APMP-attributable CVDs pose a significant threat to public health and diseases burden has increased over time, particularly in male, old-aged populations. The governments and health systems should take measures to reduce air pollution to impede this rising trend.

摘要

背景

环境细颗粒物污染(APMP)是全球心血管疾病(CVD)的主要环境风险因素。需要进行最新的综合研究,以提供全球流行病学模式。

方法

从全球疾病负担研究(GBD)2019 中获取了与 APMP 相关的 CVD 负担的详细数据。我们计算了估计的年变化百分比(EAPC),以评估 30 年来死亡率和伤残调整生命年(DALYs)的年龄标准化率的时间趋势。

结果

全球范围内,APMP 导致的 CVD 导致 248 万人死亡和 6091 万人 DALYs,分别比 1990 年增加了 122%。总体而言,男性的负担明显高于女性,但差距可能会缩小。就年龄分布而言,APMP 导致的 CVD 死亡和 DALYs 主要发生在老年人群(>70 岁)。由于 APMP 的高暴露,中低收入地区因 CVD 负担较高,与高收入地区相比,差距可能进一步扩大。就地区而言,APMP 相关 CVD 死亡率和 DALYs 的最高年龄标准化率主要出现在中亚,而最低的则出现在澳大拉西亚。在国家层面上,ASDR 下降幅度最大的国家主要集中在西欧,而赤道几内亚、东帝汶和不丹在这一时期则呈现出相对较快的增长。

结论

APMP 导致的全球 CVD 负担导致了空间和时间分布的异质性。APMP 相关的 CVD 死亡已从高 SDI 地区大幅转移到 SDI 较低的地区。全球范围内,APMP 导致的 CVD 对公共健康构成了重大威胁,疾病负担随着时间的推移而增加,特别是在男性和老年人群中。政府和卫生系统应采取措施减少空气污染,以遏制这一上升趋势。

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