Burden of cardiovascular disease among the Western Pacific region and its association with human resources for health, 1990–2021: a systematic analysis of the Global Burden of Disease Study 2021

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-09-03 DOI:10.1016/j.lanwpc.2024.101195
Huan Wang , Xiaoran Yu , Jianhui Guo , Sheng Ma , Yunfei Liu , Yifei Hu , Jing Li , Yi Song , Zhiyong Zou
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Abstract

Background

A comprehensive profile of cardiovascular disease (CVD) burden and human resources for health (HRH) distribution in the WHO Western Pacific region has yet to be presented. Studies on the relationship between HRH and CVD in this region are limited. We aimed to describe CVD trends and HRH density in the Western Pacific region and explore the association of HRH with CVD burden.

Methods

Estimates of CVD deaths and disability-adjusted life years (DALYs) were obtained from the Global Burden of Disease Study (GBD) 2021, and the annual density of HRH was retrieved from GBD 2019. We presented trends in CVD burden and HRH density across 31 Western Pacific countries. Spearman rank correlation analysis and generalized linear models were used to examine associations between CVD burden and HRH density.

Findings

In 2021, CVD caused six million deaths and 125 million DALYs in the Western Pacific region, accounting for 39.4% and 22.5% of all-cause deaths and DALYs. From 1990 to 2021, the number of CVD deaths and DALYs increased by 94.9% and 57.3% in this region, whereas the age-standardized rate of CVD deaths and DALYs declined in all countries. In 2021, stroke and ischemic heart disease were the leading causes in the Western Pacific region, and a 32-year increase in CVD burden was primarily driven by aortic aneurysm, lower extremity peripheral arterial disease, endocarditis, and atrial fibrillation and flutter. In 2019, there was an approximately 20-fold difference in HRH density across 31 countries from the lowest in Papua New Guinea to the highest in Australia. HRH density was negatively related to the age-standardized rate of CVD deaths (rs = −0.74) and DALYs (rs = −0.73), especially strong associations between CVD burden and the density of dentistry personnel, aides & emergency medical workers, and medical laboratory technicians.

Interpretation

CVD remains a pressing public health issue in the Western Pacific region where noticeable shortages in health workers exist. The negative associations between CVD burden and HRH density suggest that health workers, especially dentistry personnel, aides & emergency medical staff, and medical laboratory technicians merit more investment to reduce the CVD burden.

Funding

National Natural Science Foundation of China (82073573 to ZZ; 82273654 to YS).

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1990-2021 年西太平洋地区心血管疾病负担及其与卫生人力资源的关系:对 2021 年全球疾病负担研究的系统分析
背景世界卫生组织西太平洋地区心血管疾病(CVD)负担和卫生人力资源(HRH)分布的综合概况尚未公布。有关该地区卫生人力资源与心血管疾病之间关系的研究十分有限。我们旨在描述西太平洋地区心血管疾病的趋势和卫生人力资源的密度,并探讨卫生人力资源与心血管疾病负担之间的关系。方法心血管疾病死亡人数和残疾调整生命年(DALYs)的估计值来自《全球疾病负担研究》(GBD)2021,卫生人力资源的年度密度来自《全球疾病负担研究》2019。我们介绍了 31 个西太平洋国家心血管疾病负担和人力资源密度的趋势。研究结果2021年,心血管疾病在西太平洋地区造成600万人死亡和1.25亿人残疾调整寿命年数,分别占全因死亡和残疾调整寿命年数的39.4%和22.5%。从 1990 年到 2021 年,该地区的心血管疾病死亡人数和残疾调整寿命年数分别增加了 94.9% 和 57.3%,而所有国家的心血管疾病死亡人数和残疾调整寿命年数的年龄标准化比率均有所下降。2021 年,中风和缺血性心脏病是西太平洋地区的主要病因,主动脉瘤、下肢外周动脉疾病、心内膜炎以及心房颤动和扑动是心血管疾病负担增加 32 年的主要原因。2019年,31个国家的人力资源密度相差约20倍,从最低的巴布亚新几内亚到最高的澳大利亚。人力资源密度与心血管疾病年龄标准化死亡率(rs = -0.74)和残疾调整寿命年数(DALYs)(rs = -0.73)呈负相关,尤其是心血管疾病负担与牙科人员、助产士、急诊医务人员和医学实验室技术人员的密度之间的关联性更强。心血管疾病负担与医护人员密度之间的负相关表明,医护人员,尤其是牙科人员、助理及急诊医护人员和医学实验室技术人员值得更多投资,以减轻心血管疾病负担。
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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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