Burden of aortic aneurysm in China from 1990 to 2021: A comparative analysis with G20 countries based on the Global Burden of Disease Study 2021

OBJECTIVES: Aortic aneurysm (AA) is a life-threatening disease with high mortality. Up-to-date, information on AA burden in China is limited, which is required for health-care planning, resource allocation, and disease prevention. This study investigated the burden of AA in China from 1990 to 2021, and then compared it with other G20 countries. STUDY DESIGN: A comprehensive analysis of the Global Burden of Disease Study 2021 data. METHODS: Estimates of mortality and years of life lost (YLLs) for AA were generated from the Global Burden of Diseases Study (GBD) 2021. Mortality was estimated from vital registration data with the cause of death ensemble model, and YLLs were calculated with the use of standard GBD lifetables. The age-specific and sex-specific patterns, attributable risk factors, and trends regarding the burden of AA in China as well as other G20 nations were summarized. RESULTS: In 2021, there were an estimated 9.04 thousand (95 % uncertainty interval 7.04 to 11.58) deaths due to AA in China, representing a 241.29 % increase since 1990. The age-standardised death rate was 0.46 per 100,000 (0.36-0.59), with a 37.27 % increase from 1990 to 2021. The 2021 YLLs count was 242.11 thousand (185.41-315.41) in China, an increase of 180.74 %, with an age-standardised YLLs rate of 12.4 per 100,000 (9.54-16.09), an increase of 38.89 % since 1990. Both mortality and YLLs were higher in males than in females within all age groups. An upward trend with age in mortality and YLLs was observed. In 2021, smoking remained a major attributable risk factor for AA burden in Chinese males, but high systolic blood pressure was the major factor in females. Furthermore, high body-mass index has risen to the top three risk factors both in males and females. Compared with G20 countries, China was ranked 10th in deaths number in 1990 and then increased to 6th in 2021, and YLLs also increased from 5th to 4th. From 1990 to 2021, unlike China, most G20 countries presented decreased age-standardised rates of death and YLLs, with the largest decrease in Australia, Canada, United Kingdom, and United States of America. CONCLUSIONS: AA remains a serious threat to public health in China, especially for the male and elderly population. Smoking, high systolic blood pressure, and high body-mass index were major attributable risk factors for AA in China. Targeted and cost-effective interventions are urgently needed in China to reduce this burden.