Table_3_Estimates of the global, regional, and national burden of atrial fibrillation in older adults from 1990 to 2019: insights from the Global Burden of Disease study 2019.DOCX

BackgroundAtrial fibrill ation (AF) is a predominant public health concern in older adults. Therefore, this study aimed to explore the global, regional, and national burden of AF in older adults aged 60–89 between 1990 and 2019.MethodsThe morbidity, mortality, disability-adjusted life years (DALYs), and age-standardized rates of AF were refined from the Global Burden of Diseases study 2019. The epidemiological characteristics were assessed based on numerical values, age-standardized rates per 100,000 person-years, and estimated annual percentage changes (EAPC).ResultsGlobally, a total of 33.31 million AF cases, 219.4 thousand deaths, and 65.80 million DALYs were documented in 2019. There were no appreciable changes in EAPC from 1990 to 2019. The disease burden of AF differed significantly across different territories and countries. At the national level, China exhibited the highest number of incident cases [818,493 (562,871–1,128,695)], deaths [39,970 (33,722–46,387)], and DALYs [1,383,674 (1,047,540–1,802,516)]. At the global level, high body mass index (BMI) and high systolic blood pressure (SBP) were two predominant risk factors contributing to the proportion of AF-related deaths.ConclusionAF in older adults remains a major public health concern worldwide. The burden of AF varies widely at both national and regional levels. From 1990 to 2019, the cases of incidences, deaths, and DALYs have shown a global increase. The ASIR, ASMR, and ASDR have declined in the high-moderate and high SDI regions; however, the burden of AF increased promptly in the lower SDI regions. Special attention should be paid to the main risk factors for high-risk individuals with AF, which can help control systolic blood pressure and body mass index within normal limits. Over all, it is necessary to illustrate the features of the global AF burden and develop more effective and targeted prevention and treatment strategies.

背景心房颤动（AF）是老年人中主要的公共卫生问题。因此，本研究旨在探讨1990年至2019年间全球、地区和国家层面60至89岁老年人AF的疾病负担。方法本研究从2019年全球疾病负担研究中精炼了AF的发病率、死亡率、伤残调整生命年（DALYs）和年龄标准化率。基于数值、每10万人年年龄标准化率和估计的年度百分比变化（EAPC）评估了流行病学特征。结果2019年全球记录了总计33.31百万AF病例、21.94千人死亡和65.80百万DALYs。从1990年到2019年，EAPC没有显著变化。AF的疾病负担在不同地区和国家之间存在显著差异。在国家层面，中国表现出最多的新发病例[818,493（562,871–1,128,695）]、死亡[39,970（33,722–46,387）]和DALYs[1,383,674（1,047,540–1,802,516）]。在全球层面，高体质指数（BMI）和高收缩压（SBP）是导致AF相关死亡比例的两个主要风险因素。结论老年人AF仍然是全球性的主要公共卫生问题。在国家及地区层面，AF的负担差异显著。从1990年到2019年，新发病例、死亡和DALYs的病例数均呈现全球性增长。在高-中度和高社会经济发展水平地区，年龄标准化发病率（ASIR）、年龄标准化死亡率（ASMR）和年龄标准化死亡比率（ASDR）有所下降；然而，在低社会经济发展水平地区，AF的负担迅速增加。应特别关注AF高风险个体的主要风险因素，以帮助控制收缩压和体质指数在正常范围内。总体而言，有必要描绘全球AF负担的特征，并制定更有效和针对性的预防和治疗策略。