Epidemiological trends, risk factor contributions, and future projections of cardiovascular disease among Chinese adults ≥45 years: insights from GBD 2021 and CHARLS.

OBJECTIVE This study assessed epidemiological trends from 1990 to 2021, quantified risk factors contributions to CVD burden, and predicted risk-attributable mortality.

METHODS Our study combines data from the 2021 Global Burden of Disease and the China Health and Retirement Longitudinal Study (CHARLS). Joinpoint regression analyzed trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Based on CHARLS database, logistic regression was used for comorbidity analysis. BAPC models projected mortality to 2036.

RESULTS From 1990 to 2021, ASIR and ASPR increased significantly (APC = 0.12, P = 0.004; APC = 0.33, P < 0.001), while ASDR and DALYs declined (APC = -1.01, P < 0.001; APC = -1.34, P < 0.001), with males exhibiting consistently higher burden than females (P < 0.001). Among individuals aged >75 years, mortality rates exceeded 4000 per 100,000 population, and the DALYs surpassed 60,000 per 100,000 population. High systolic blood pressure was the predominant risk factor. Logistic regression analysis of CHARLS data revealed significant associations between CVD and chronic lung disease (OR = 1.78), liver disease (OR = 1.49), and kidney disease (OR = 1.85). The BAPC prediction model indicates that all CVD risk factors show declining mortality trajectories over 15 years, with sex-specific variation in contributions.

CONCLUSIONS Declining CVD mortality and rising incidence and prevalence among Chinese individuals ≥45 years marks a transition towards chronic disease management. Despite overall declines, persistently high mortality due to elevated LDL cholesterol and blood glucose necessitates targeted interventions to optimize resource allocation.