Analysis of the disease burden trend of intracerebral hemorrhage caused by high systolic blood pressure in elderly population of China from 1990 to 2023 and the age-period-cohort model

doi:10.11958/20253377

Abstract

Abstract:

Objective To systematically analyze the trends in disease burden of intracerebral hemorrhage (ICH) attributed to high systolic blood pressure among the elderly population aged ≥65 years in China from 1990 to 2023, apply the age-period-cohort (APC) model to reveal the independent effects of death risk and disease burden, and predict the disease burden of ICH attributed to high systolic blood pressure in China from 2024 to 2040. Methods Based on the data from the 2023 Global Burden of Disease (GBD) study, this study extracted the mortality and Disability-Adjusted Life Years (DALYs) data of ICH caused by high systolic blood pressure in elderly population in China. An APC model was constructed, and the study subjects were divided into 7 age groups, 7 period groups and 13 birth cohort groups. The relative risks (RR) of age, period and birth cohort on the mortality rate and DALYs rate were analyzed. The Bayesian age-period-cohort (BAPC) model was employed to forecast the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) of ICH patients caused by high systolic blood pressure in China from 2024 to 2040. Results In 2023, the number of death from ICH attributable to high systolic blood pressure in elderly population in China reached 518 845 cases, representing an increase of 8.25% compared with 1990, while DALYs decreased by 3.39%. However, the ASMR and ASDR decreased by 70.30% and 71.42%, respectively, with average annual percentage changes (AAPC) of -3.50% and -3.62%. The APC model indicated that the mortality and DALYs risk showed an initial increase and then decreased with age. The peak risk of death was between 90-94 years old, and the peak risk of DALYs was between 75-79 years old. The period effect demonstrated a sustained decline in mortality and DALYs risk from 2009. The cohort effect revealed an intergenerational improvement trend, with later-born cohorts exhibiting lower mortality and DALYs risk. The increase in the absolute number of death and the standardised rate of DALYs were increased in male than those in female, and the decrease in the absolute number and standardized rate were more significant in female. The prediction results of the BAPC model indicated that by 2040, the ASMR and ASDR of ICH in China due to high systolic blood pressure would decrease to 121.4 per 100 000 and 1 777.9 per 100 000, respectively. Conclusion From 1990 to 2023, the disease burden of ICH attributable to high systolic blood pressure in elderly population in China shows a relatively downward trend, while the aging of the population continuously increased its absolute burden. In the future, it is necessary to focus on the dual intervention of blood pressure and cerebrovascular risk for the elderly and male with hypertension.

Key words: China, mortality, intracranial hemorrhage, hypertensive, global burden of disease, disability-adjusted life years, age-period-cohort model

CLC Number:

R743.34，R195.4

Figures/Tables 7

References 24

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人群	死亡例数（95%UI）
人群	1990年	2023年	变化率/%
全人群	479 296（295 169~706 482）	518 845（334 669~729 879）	8.25
男性	225 179（135 066~345 422）	285 391（174 613~418 336）	26.74
女性	254 117（153 346~393 952）	233 454（134 750~348 464）	-8.13
人群	ASMR（95%UI）/10万
人群	1990年	2023年	变化率/%
全人群	881.29（543.39~1 305.28）	261.75（168.62~368.81）	-70.30
男性	937.58（565.02~1 442.28）	316.02（192.18~465.33）	-66.29
女性	832.01（502.70~1 297.53）	215.57（124.50~322.55）	-74.09
人群	DALYs数（95%UI）
人群	1990年	2023年	变化率/%
全人群	8 485 512（5 195 942~12 457 591）	8 197 621（5 313 964~11 457 037）	-3.39
男性	4 158 982（2 475 462~6 371 539）	4 683 188（2 903 050~6 810 069）	12.60
女性	4 326 530（2 594 222~6 678 294）	3 514 434（2 038 156~5 170 851）	-18.77
人群	ASDR（95%UI）/10万
人群	1990年	2023年	变化率/%
全人群	13 898.40（8 545.96~20 474.99）	3 972.17（2 573.81~5 556.54）	-71.42
男性	15 041.63（9 025.16~23 075.53）	4 864.71（2 997.27~7 094.18）	-67.66
女性	12 904.07（7 764.09~19 999.18）	3 182.87（1 848.20~4 692.40）	-75.33

人群	死亡例数（95%UI）
人群	1990年	2023年	变化率/%
全人群	479 296（295 169~706 482）	518 845（334 669~729 879）	8.25
男性	225 179（135 066~345 422）	285 391（174 613~418 336）	26.74
女性	254 117（153 346~393 952）	233 454（134 750~348 464）	-8.13
人群	ASMR（95%UI）/10万
人群	1990年	2023年	变化率/%
全人群	881.29（543.39~1 305.28）	261.75（168.62~368.81）	-70.30
男性	937.58（565.02~1 442.28）	316.02（192.18~465.33）	-66.29
女性	832.01（502.70~1 297.53）	215.57（124.50~322.55）	-74.09
人群	DALYs数（95%UI）
人群	1990年	2023年	变化率/%
全人群	8 485 512（5 195 942~12 457 591）	8 197 621（5 313 964~11 457 037）	-3.39
男性	4 158 982（2 475 462~6 371 539）	4 683 188（2 903 050~6 810 069）	12.60
女性	4 326 530（2 594 222~6 678 294）	3 514 434（2 038 156~5 170 851）	-18.77
人群	ASDR（95%UI）/10万
人群	1990年	2023年	变化率/%
全人群	13 898.40（8 545.96~20 474.99）	3 972.17（2 573.81~5 556.54）	-71.42
男性	15 041.63（9 025.16~23 075.53）	4 864.71（2 997.27~7 094.18）	-67.66
女性	12 904.07（7 764.09~19 999.18）	3 182.87（1 848.20~4 692.40）	-75.33

指标	趋势	年份	APC（95%CI）/%	AAPC（95%CI）/%
ASMR	1	1990—2001	-2.33（-2.58~-2.08）^＊	-3.50（-3.94~-3.05）^＊
	2	2001—2010	-5.03（-5.38~-4.67）^＊
	3	2010—2014	-7.52（-9.02~-5.99）^＊
	4	2014—2017	0.86（-2.34~4.16）
	5	2017—2020	-6.66（-9.52~-3.69）^＊
	6	2020—2023	1.42（-0.26~3.12）
ASDR	1	1990—2001	-2.36（-2.62~-2.09）^＊	-3.62（-4.08~-3.16）^＊
	2	2001—2010	-5.03（-5.40~-4.66）^＊
	3	2010—2014	-7.52（-9.06~-5.94）^＊
	4	2014—2017	0.14（-3.16~3.55）
	5	2017—2020	-7.01（-9.97~-3.96）^＊
	6	2020—2023	1.25（-0.47~3.01）

指标	趋势	年份	APC（95%CI）/%	AAPC（95%CI）/%
ASMR	1	1990—2001	-2.33（-2.58~-2.08）^＊	-3.50（-3.94~-3.05）^＊
	2	2001—2010	-5.03（-5.38~-4.67）^＊
	3	2010—2014	-7.52（-9.02~-5.99）^＊
	4	2014—2017	0.86（-2.34~4.16）
	5	2017—2020	-6.66（-9.52~-3.69）^＊
	6	2020—2023	1.42（-0.26~3.12）
ASDR	1	1990—2001	-2.36（-2.62~-2.09）^＊	-3.62（-4.08~-3.16）^＊
	2	2001—2010	-5.03（-5.40~-4.66）^＊
	3	2010—2014	-7.52（-9.06~-5.94）^＊
	4	2014—2017	0.14（-3.16~3.55）
	5	2017—2020	-7.01（-9.97~-3.96）^＊
	6	2020—2023	1.25（-0.47~3.01）

效应	年份	ASMR[RR（95%CI）]	ASDR[RR（95%CI）]
时期效应	1989—1993	1.70（1.59~1.82）^＊	1.66（1.54~1.79）^＊
	1994—1998	1.47（1.39~1.57）^＊	1.45（1.36~1.55）^＊
	1999—2003	1.31（1.24~1.38）^＊	1.30（1.23~1.37）^＊
	2004—2008	1.00	1.00
	2009—2013	0.77（0.73~0.82）^＊	0.77（0.73~0.82）^＊
	2014—2018	0.64（0.60~0.68）^＊	0.63（0.59~0.68）^＊
	2019—2023	0.57（0.53~0.62）^＊	0.55（0.51~0.60）^＊
出生队列效应	1892—1896	2.50（1.19~5.29）^＊	2.57（0.92~7.16）
	1897—1901	2.20（1.68~2.89）^＊	2.23（1.56~3.20）^＊
	1902—1906	1.95（1.71~2.21）^＊	1.97（1.68~2.31）^＊
	1907—1911	1.77（1.63~1.93）^＊	1.80（1.64~1.98）^＊
	1912—1916	1.50（1.40~1.60）^＊	1.51（1.41~1.62）^＊
	1917—1921	1.24（1.17~1.31）^＊	1.25（1.18~1.32）^＊
	1922—1926	1.00	1.00
	1927—1931	0.83（0.79~0.88）^＊	0.83（0.79~0.87）^＊
	1932—1936	0.68（0.64~0.72）^＊	0.67（0.64~0.71）^＊
	1937—1941	0.52（0.49~0.56）^＊	0.53（0.50~0.56）^＊
	1942—1946	0.42（0.39~0.45）^＊	0.43（0.40~0.45）^＊
	1947—1951	0.33（0.31~0.36）^＊	0.34（0.32~0.37）^＊
	1952—1956	0.23（0.20~0.26）^＊	0.24（0.22~0.26）^＊