The online version of this article (https://doi.org/10.1186/s12872-018-0761-0) contains supplementary material, which is available to authorized users.
Ischaemic heart disease (IHD) is a major barrier to sustainable human development, but its health burden and geographic distribution among provinces of China remain unclear. This study aimed to estimate IHD burden in provinces of China, and attributable to risk factors from 1990 to 2015.
Data were collected from the Global Burden of Disease 2015 Study, which evaluated IHD burden and attributable risk factors using deaths and disability-adjusted life years (DALYs). Statistical models including cause of death ensemble modelling, Bayesian meta-regression analysis, and comparative risk assessment approaches were applied to reduce bias and produce comprehensive results of IHD deaths, DALYs and attributable risks. The 95% uncertainty intervals (UIs) were calculated and reported for mortality and DALYs.
The age-standardised death rate per 100,000 people increased by 13.3% from 101.3 (95%UI: 95.3–107.5) to 114.8 (95%UI: 109.8–120.1) from 1990 to 2015 in China, whereas the age-standardised DALY rate declined 3.9% to 1760.2 per 100,000 people (95%UI: 1671.6–1864.3). In 2015, the age-standardised death rate per 100,000 people was the highest in Heilongjiang (187.4, 95%UI: 161.6–217.5) and the lowest in Shanghai (44.2, 95%UI: 37.0–53.1), and the age-standardised DALY rate per 100,000 people was the highest in Xinjiang (3040.8, 95%UI: 2488.8–3735.4) and the lowest in Shanghai (524.4, 95%UI: 434.7–638.4). Geographically, the age-standardised death and DALY rates for southern provinces were lower than northern provinces, especially in southeastern coastal provinces. 95.3% of the IHD burden in China was attributable to environmental, behavioural and metabolic risk factors. The five leading IHD risks in 2015 were high systolic blood pressure, high total cholesterol, diet high in sodium, diet low in whole grains, and smoking.
Population growth and ageing has led to a steady increase in the IHD burden. Regional disparities in IHD burden were observed in provinces of China. The distribution characteristics of IHD burden provide guidance for decision makers to formulate targeted preventive policies and interventions.
Additional file 1: ᅟ. (DOCX 18 kb)12872_2018_761_MOESM1_ESM.docx
Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, Casey DC, Charlson FJ, Chen AZ, Coates MM, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1459–544. CrossRef
Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown J, Carter A, Casey DC, Charlson FJ, Coates MM, Coggeshall M, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1603–58. CrossRef
Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, Carter A, Casey DC, Charlson FJ, Chen AZ, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1545–602. CrossRef
Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, Brauer M, Burnett R, Cercy K, Charlson FJ, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1659–724. CrossRef
Aalami Harandi S, Sarrafzadegan N, Sadeghi M, Talaei M, Dianatkhah M, Oveisgharan S, Pourmoghaddas A, Salehi A, Sedighifard Z. Do Cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke? Res Cardiovasc Med. 2016; https://doi.org/10.5812/cardiovascmed.30619.
Cooper R, Cutler J, Desvigne-Nickens P, Fortmann SP, Friedman L, Havlik R, Hogelin G, Marler J, McGovern P, Morosco G, et al. Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation. 2000;102(25):3137–47. CrossRefPubMed
World Health Organization, World Heart Federation, World Stroke Organization. Global atlas on cardiovascular disease prevention and control: policies, strategies and interventions. 2011. http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/. Accessed 12 Sept 2016.
National Health and Family Planning Commission of the People's Republic of China. The plan of healthy China 2030. 2016. http://www.nhfpc.gov.cn/xcs/wzbd/201610/21d120c917284007ad9c7aa8e9634bb4.shtml. Accessed 25 Oct 2016.
Lim SS, Allen K, Bhutta ZA, Dandona L, Forouzanfar MH, Fullman N, Gething PW, Goldberg EM, Hay SI, Holmberg M, et al. Measuring the health-related sustainable development goals in 188 countries: a baseline analysis from the global burden of disease study 2015. Lancet. 2016;388(10053):1813–50. CrossRef
Barker-Collo S, Bennett DA, Krishnamurthi RV, Parmar P, Feigin VL, Naghavi M, Forouzanfar MH, Johnson CO, Nguyen G, Mensah GA, et al. Sex differences in stroke incidence, prevalence, mortality and disability-adjusted life years: results from the global burden of disease study 2013. Neuroepidemiology. 2015;45(3):203–14. CrossRefPubMedPubMedCentral
World Health Organization. WHO framework convention on tobacco control. World Health Organization. 2003. http://www.who.int/fctc/text_download/en/. Accessed 10 Nov 2017.
World Health Organization. Global strategy on diet, physical activity and health. World Health Organization. 2004. http://www.who.int/dietphysicalactivity/goals/en/. Accessed 10 Nov 2017.
World Health Organization. Global strategy to reduce the harmful use of alcohol. World Health Organization, 2010. http://www.who.int/substance_abuse/publications/global_strategy_reduce_harmful_use_alcohol/en/. Accessed 9 Nov 2017.
Yang J, Wang ZQ, Zhao YF, Li YC, Yin P, Liu SW, You JL, Zhou MG. Burden of disease attributed to high total cholesterol in 2013 in China. Zhonghua Yu Fang Yi Xue Za Zhi. 2016; https://doi.org/10.3760/cma.j.issn.0253-9624.2016.09.004.
National Center for Disease Control and Prevention of China. Report on adults tobacco survey in 14 Chinese cities, 2013–2014. http://www.tcrc.org.cn/html/zy/cbw/jc/3192.html. Accessed 20 Aug 2015.
Ebenstein A, Fan M, Greenstone M, He G, Yin P, Zhou M. Growth, pollution, and life expectancy: China from 1991-2012. American Economic Review: Papers & Proceedings. 2015;105(5):226–31. CrossRef
National Bureau of Statistics of the People’s Republic of China, National data. 2017. http://www.stats.gov.cn. Accessed 9 Nov 2017.
Zhang R, Wang Z, Fei Y, Zhou B, Zheng S, Wang L, Huang L, Jiang S, Liu Z, Jiang J, et al. The difference in nutrient intakes between Chinese and Mediterranean. Japanese and American Diets Nutrients. 2015;7(6):4661–88. PubMed
National Center for Cardiovascular Diseases of China. Report on cardiovascular diseases in China. 2016. http://www.nccd.org.cn/News/Columns/Index/1089. Accessed 3 Aug 2017.
Turk-Adawi K, Sarrafzadegan N, Fadhil I, Taubert K, Sadeghi M, Wenger NK, Tan NS, Grace SL. Cardiovascular disease in the eastern Mediterranean region: epidemiology and risk factor burden. Nat Rev Cardiol. 2017; https://doi.org/10.1038/nrcardio.2017.138.
- Burden of Ischaemic heart disease and attributable risk factors in China from 1990 to 2015: findings from the global burden of disease 2015 study
- BioMed Central
Neu im Fachgebiet Kardiologie
Mail Icon II