Analysis of disease burden of ischemic heart disease attributed to tobacco in china and globally:Current status and trends from 1990 to 2021

YAN Yu-ming; FU Hong-li; GUAN Li-chun; YU min

doi:10.3969/j.issn.1672-5301.2025.04.015

Abstract：Objective To assess the current status and trends of the disease burden of ischemic heart disease(IHD)attributable to tobacco use in China and globally from 1990 to 2021,and to further explore the influence of gender,age and socioeconomic development levels on the disease burden,providing scientific evidence for optimizing tobacco control policies and intervention strategies.Methods Data on the disease burden of IHD attributable to tobacco use were extracted from the Global Burden of Disease Study 2021(GBD 2021)for the years 1990 to 2021.The key indicators analyzed included the number of deaths,mortality rates,disability-adjusted life years(DALY),age-standardized mortality rates(ASMR)and age-standardized DALY rates(ASDR).Temporal trends were examined using the Joinpoint regression model to calculate the annual percentage change(APC)and the average annual percentage change(AAPC).Additionally,regional trends were compared based on the sociodemographic index(SDI),while the gender and age distributions of the disease burden were analyzed.Results From 1990 to 2021,the number of deaths and DALYs attributable to tobacco use in China increased significantly by 184.34％and 121.12％,respectively.However,ASMR and ASDR in China showed no significant changes during this period.Globally,ASMR and ASDR decreased by 40.43％and 39.95％,respectively,with the most pronounced reductions observed in high-SDI regions,while declines were more modest in low-SDI regions.The tobacco-related IHD disease burden was significantly higher among men than women,with second-hand smoke exposure having a notable impact on women.The burden increased with age,peaking among the elderly population.Conclusion Despite substantial global advancements in tobacco control policies,public health education,and smoking cessation initiatives,the tobacco-attributable IHD burden in China remains substantial,particularly among men and older adults.Strengthening tobacco control legislation and policy implementation,along with optimizing public health interventions,is essential.Efforts should focus on promoting smoke-free environments in low-SDI regions and implementing targeted interventions for high-risk groups,including measures to mitigate second-hand smoke exposure.This study provides valuable insights for refining IHD prevention and control strategies in China and worldwide.