Death, disability from rheumatic heart disease decreased globally from 1990 to 2019
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Despite an increased incidence and prevalence of rheumatic heart disease worldwide from 1990 to 2019, death and disability caused by the condition trended downward, according to data published in Arthritis Research & Therapy.
“Due to the high risks of premature morbidity, mortality and disability, [rheumatic heart disease (RHD)] remains a critical public health issue worldwide, particularly in many low-income countries,” Zejin Ou, PhD, of Guangzhou Twelfth People’s Hospital, in Guangzhou, China, and co-authors wrote. “Advances in diagnosis and surgery had promoted the changes in the epidemiological pattern of RHD. Therefore, tracking the temporal trends of RHD burden is necessary for health strategies.”
To analyze global trends in rheumatic heart disease across regional and national boundaries from 1990 through 2019, Ou and colleagues collected data from the Global Burden of Disease study, using the Global Health Data Exchange tool. The researchers extracted information including disease incidence, prevalence, death and disability-adjusted life years (DALY). Data were collected for the years spanning 1990 through 2019, and were available from 21 regions and 204 countries or territories, the authors wrote.
The Global Burden of Disease study summarized data from 46,749 cohort studies, randomized trials and surveys, allowing the researchers to quantify risks and exposures. The researchers also categorized risks related to death and DALYs into three groups, including metabolic risks, behavioral risks and environmental or occupational risks.
According to the authors, there were increasing trends worldwide in the age-standardized rate of increasing prevalence and incidence of RHD between 1990 and 2019. The estimated annual percentage change (EAPC) of the incidence of RHD worldwide was 0.58 (95% CI, 0.52-0.63), and the prevalence EAPC was 0.57 (95% CI, 0.5–0.63). Trends largely increased among the low- and middle-Socio-Demographic Index regions and countries. Among these, the largest increases were in Fiji, which saw an EAPC incidence increase of 2.17 (95% CI, 1.48-2.86) and a prevalence increase of 2.22 (95% CI, 1.53-2.91).
However, death and DALYs demonstrated “pronounced” decreasing trends, according to the researchers. There was a decreasing incidence and prevalence, in which the EAPCs were –2.98 (95% CI, –3.03 to –2.94) and –2.7 (95% CI, –2.75 to –2.65), respectively. The largest decreasing trends for death were in Thailand, with and EAPC of –9.55 (95% CI, –10.48 to –8.61).
“Pronounced decreasing trends of death and DALYs due to RHD were observed worldwide from 1990 to 2019, indicating progress in the current management and treatment of RHD,” Ou and colleagues wrote. “However, the increasing trends of incidence and prevalence indicated that RHD remains a substantial challenge globally, and more effective strategies are needed for the prevention and control of the disease.”
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