THIRTY-YEAR TREND OF NON-RHEUMATIC VALVULAR HEART DISEASE: A COMPARISON OF PAKISTAN WITH SOUTH ASIA AND GLOBAL SCENARIO

Objectives: This study aimed to evaluate the burden and trends of non-rheumatic valvular heart disease (VHD) in Pakistan compared to the South Asian (SA) and Global figures based on estimates of the Global Burden of Disease (GBD) study for the years 1990 to 2019. Methodology: Data for the estimated prevalence, deaths, and disability-adjusted life years (DALYs), along with age-standardized death rate (ASDR) due to non-rheumatic VHD in Pakistan, was extracted from the GBD study. Results: The prevalence of non-rheumatic VHD in Pakistan increased by 14.1% from 1990 to 2019, from 6.4 to 7.3/100,000. The ASDR per 100,000 population has shown a 12.9% increase between the years 1990 and 2019 (from 1.32 to 1.49) with an IRR of 1.102 [1.002-1.1983]. However, global and SA's decreased slightly with an IRR of 0.997 [0.971-1.024] and 0.996 [0.959-1.034]. The estimated number of deaths has shown a 1.1% increase from 0.6 to 0.6/100,000 from 1990 to 2019. Similarly, the estimated number of DALYs has shown an increased (17%) from 14.1 in 1990 to 16.5/100,000 in 2019. Interestingly, Sindh, Baluchistan, and Azad Jammu & Kashmir also had seen the most significant increase in DALYs over 30 years, accounting for 30.3%, 23.7%, and 23.9% respectively. Conclusion: Based on the analysis of GBD estimates, it can be concluded that, in Pakistan, the prevalence, deaths, and DALYs rate of non-rheumatic VHD per 100 thousand individuals increased substantially between 1990 and 2019. The age-standardized death rate also significantly increased over the past 30 years.