LIN Derong , ZHOU Yifu , ZHANG Mina , LI Yue , LIANG Jingrong , XUE Aiguo , LI Xiulan
  • Department of Acupuncture, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, 523000, Guangdong, P. R. China;
LI Xiulan, Email: yintong0608@126.com
Ischemic heart disease; ischemic stroke; chronic kidney disease; risk factors; Global Burden of Disease Study
10.7507/1007-4848.202606039
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Objective  To separately analyze the burden and temporal trends of ischemic heart disease, ischemic stroke, and chronic kidney disease (CKD) attributable to eight prespecified behavioral and metabolic risk factors in China from 1990 to 2023. Methods  Disability-adjusted life years (DALYs) and age-standardized DALY rate (ASDR) attributable to high systolic blood pressure, high fasting plasma glucose, high body-mass index, diet high in sodium, diet low in whole grains, diet low in fruits, diet low in vegetables, and low physical activity were extracted for the three diseases from the Global Burden of Disease Study 2023 (GBD 2023) database. Estimated annual percentage change (EAPC), comparisons across the five original BRICS countries, sex- and age-stratified patterns, and autoregressive integrated moving average projections were analyzed. Results  In 2023, high systolic blood pressure was the leading attributable risk for ischemic heart disease and ischemic stroke, with attributable DALYs of 19 643 280 person-years and 10 851 413 person-years, and ASDR of 885.65 person-years per 100 000 population and 475.69 person-years per 100 000 population, respectively. High fasting plasma glucose was the leading risk for CKD, with 1 783 113 person-years of DALYs and an ASDR of 78.97 person-years per 100 000 population. The ASDR of ischemic heart disease attributable to high body-mass index increased [EAPC=0.46%, 95%CI (0.35%, 0.57%)]. China had the highest DALYs attributable to high systolic blood pressure for ischemic heart disease and ischemic stroke among the five original BRICS countries in 2023. For CKD, the leading attributable risk was high fasting plasma glucose in China and India, high body-mass index in Brazil and South Africa, and high systolic blood pressure in Russia. For the three diseases in 2023, the ASDR associated with the leading attributable risk factor was higher in males than in females. The burdens attributable to the leading risks were concentrated among people aged ≥70 years for ischemic heart disease and ischemic stroke and among those aged 50-69 years for CKD. Projections suggested that DALYs attributable to the leading risks would remain high during 2024-2035. Conclusion  High systolic blood pressure is the leading attributable risk for ischemic heart disease and ischemic stroke, whereas high fasting plasma glucose is the leading risk for CKD. Disease-specific risk management targeting blood pressure control, salt reduction, glycemic management, body weight control, and early kidney screening should be strengthened in China.

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