Data Sheet 1_Non-rheumatic calcific aortic valve disease in China: findings from the Global Burden of Disease study 2021.pdf

BackgroundOver the past 30 years, rapid population aging has made non-rheumatic calcific aortic valve disease (NR-CAVD) a growing public health concern in China. However, its long-term epidemiological trends and future disease burden remain unclear. This study aimed to comprehensively assess temporal trends in NR-CAVD in China from 1990 to 2021 and to predict its disease burden over the next 30 years from the Global Burden of Disease (GBD) 2021 data.
MethodsData on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of NR-CAVD were retrieved from the GBD 2021 database, and estimated annual percentage changes (EAPCs) were calculated. Temporal patterns were evaluated using an age–period–cohort (APC) model, while Joinpoint regression was applied to identify key inflection points. Future trends were projected through a Bayesian APC (BAPC) model based on integrated nested Laplace approximation.
ResultsFrom 1990 to 2021, the age-standardized prevalence and incidence of NR-CAVD in China increased significantly (EAPC for prevalence: 2.33%, incidence: 2.03%), whereas mortality (EAPC =−1.34%) and DALYs (EAPC =−1.06%) showed a continuous decline. In 2021, adults aged ≥65 years accounted for more than two-thirds of total cases, with men showing higher age-standardized rates than women. Joinpoint analysis revealed an accelerated increase after 2005, and BAPC projections indicated that incidence will continue to rise through 2050, particularly among individuals aged 70–74 years.
ConclusionsAlthough mortality and DALYs associated with NR-CAVD have gradually declined in China, the overall disease burden continues to increase due to population aging. Preventive strategies should prioritize adults over 50 years of age and integrate early screening alongside targeted interventions to reduce future cardiovascular risks.

背景 过去30年间，人口快速老龄化使得非风湿性钙化性主动脉瓣疾病（non-rheumatic calcific aortic valve disease, NR-CAVD）逐渐成为中国日益严峻的公共卫生问题。然而，该疾病的长期流行病学趋势与未来疾病负担仍尚不明确。本研究依托2021年全球疾病负担（Global Burden of Disease, GBD）数据库数据，旨在全面评估1990年至2021年中国NR-CAVD的时间变化趋势，并预测未来30年的疾病负担。
方法 本研究从2021年GBD数据库中提取NR-CAVD的发病率、患病率、死亡率及残疾调整生命年（disability-adjusted life years, DALYs）数据，并计算估计年度百分比变化（estimated annual percentage changes, EAPCs）。采用年龄-时期-队列（age–period–cohort, APC）模型分析其时间分布特征，通过Joinpoint回归识别关键拐点。基于集成嵌套拉普拉斯近似（integrated nested Laplace approximation）的贝叶斯APC（Bayesian APC, BAPC）模型用于预测未来疾病趋势。
结果 1990年至2021年，中国NR-CAVD的年龄标准化患病率与发病率均呈显著上升趋势（患病率EAPC为2.33%，发病率EAPC为2.03%），而死亡率（EAPC=-1.34%）与DALYs（EAPC=-1.06%）则持续下降。2021年，≥65岁成年人占总病例数的三分之二以上，且男性年龄标准化率高于女性。Joinpoint分析显示，2005年后该病增长趋势加速；BAPC模型预测显示，至2050年发病率将持续上升，尤以70~74岁人群最为显著。
结论 尽管中国NR-CAVD相关的死亡率与DALYs已逐步下降，但受人口老龄化影响，整体疾病负担仍持续攀升。预防策略应优先覆盖50岁以上成年人，整合早期筛查与针对性干预措施，以降低未来心血管疾病风险。