Data Sheet 5_Global, regional, and national burden of IHD attributable to PM pollution aged 70 and above: an age-period-cohort modeling and frontiers analysis study.csv

BackgroundParticulate matter (PM) pollution is a significant risk factor for ischemic heart disease (IHD). This study evaluates the global, regional, and national burden of IHD attributable to PM pollution from 1990 to 2021, quantifies key contributing factors, and projects trends to 2044, with a focus on regional disparities and population aging.
MethodsUsing data from the Global Burden of Disease (GBD) 2021 study, we analyzed trends in IHD-related disability-adjusted life years (DALYs) and mortality attributable to PM pollution. Joinpoint regression assessed long-term trends, Age-Period-Cohort modeling evaluated demographic drivers, and decomposition analysis identified the contributions of population growth, aging, and epidemiological changes. Frontier analysis compared observed DALY rates with the lowest achievable rates based on socio-demographic index (SDI). Future trends were projected using the Nordpred model.
ResultsFrom 1990 to 2021, global age-standardized DALY rates for IHD attributable to PM pollution decreased by −1.51% annually, but absolute DALYs increased due to population aging and growth. High SDI regions saw significant declines in DALY rates (−4.75% annually), while Low SDI regions experienced negligible change (0.01%). Population growth contributed to a 183.57% increase in global DALYs, but epidemiological improvements reduced the burden by 89.29%. Frontier analysis revealed substantial unrealized potential for reducing the IHD burden, particularly in Middle SDI regions. Projections to 2044 indicate that while DALY rates will decline, total DALYs will increase among individuals aged over 70, especially in Low and Low-middle SDI regions.
ConclusionsThis study highlights substantial progress in reducing the IHD burden attributable to PM pollution, particularly in High SDI regions. However, disparities remain, especially in Low and Low-middle SDI regions, where the aging population and insufficient healthcare infrastructure exacerbate the burden. The rising IHD burden among the older adult underscores the need for targeted interventions, including stricter air quality regulations, enhanced healthcare access, and policies that specifically address vulnerable populations. Strengthening healthcare systems and air pollution controls in these regions is critical to mitigating the growing IHD burden in the coming decades.

研究背景
颗粒物（Particulate matter，PM）污染是缺血性心脏病（ischemic heart disease，IHD）的重要危险因素。本研究评估了1990年至2021年全球、区域及国家层面由PM污染所致缺血性心脏病的疾病负担，量化了关键致病因素，并预测至2044年的疾病变化趋势，重点关注区域差异与人口老龄化问题。

研究方法
本研究依托全球疾病负担（Global Burden of Disease，GBD）2021研究的数据，分析了PM污染所致缺血性心脏病相关伤残调整寿命年（disability-adjusted life years，DALYs）与死亡病例的变化趋势。采用连接点回归（Joinpoint regression）分析长期变化趋势，通过年龄-时期-队列模型（Age-Period-Cohort modeling）评估人口学驱动因素，并通过分解分析明确了人口增长、人口老龄化与流行病学变化的贡献度。前沿分析对比了基于社会人口学指数（socio-demographic index，SDI）的实际DALY率与可达到的最低DALY率。未来趋势预测采用Nordpred模型完成。

研究结果
1990年至2021年，全球PM污染所致缺血性心脏病的年龄标化DALY率年均下降1.51%，但因人口老龄化与人口增长，绝对DALY总量有所上升。高SDI区域的DALY率出现显著下降（年均下降4.75%），而低SDI区域几乎无变化（仅0.01%）。人口增长使全球DALY总量增加183.57%，但流行病学层面的改善则使疾病负担降低了89.29%。前沿分析显示，PM污染所致缺血性心脏病的疾病负担存在大量未被发掘的减排潜力，尤其在中SDI区域更为突出。至2044年的预测结果表明，尽管DALY率将持续下降，但70岁以上人群的总DALY量将有所上升，尤其在低SDI与中低SDI区域更为显著。

研究结论
本研究表明，在降低PM污染所致缺血性心脏病疾病负担方面已取得显著进展，尤其在高SDI区域。但区域差异依然存在，尤其在低SDI与中低SDI区域，人口老龄化与医疗基础设施不足进一步加重了疾病负担。老年人群缺血性心脏病负担的上升凸显了开展针对性干预的必要性，包括更严格的空气质量管控法规、提升医疗服务可及性，以及针对脆弱人群的专项政策。加强这些地区的医疗体系建设与空气污染管控，对未来数十年内缓解缺血性心脏病负担的增长至关重要。