Age-Period-Cohort analysis and future trend projections of the burden of non-rheumatic calcific aortic valve disease in older adults in China and Worldwide,1993-2023
FU Hong-li
YAN Yu-ming
GUAN Li-chun
YU Min
Abstract：Objective To explore the current status,trends,driving factors and future projections of the burden of non-rheumatic calcific aortic valve disease(NR-CAVD)in China and globally from 1993 to 2023,providing a scientific basis for formulating and optimizing public health prevention and control strategies for elderly NR-CAVD in China.Methods This study is based on the Global Burden of Disease Study 2023 database,extracting data related to the burden of NR-CAVD in populations aged 60 and above in China and globally from 1993 to 2023.The primary indicators include age-standardized mortality mate(ASMR);age-standardized incidence rate(ASIR);age-standardized prevalence rate(ASPR).The age-period-cohort(APC)model was used to decompose age,period,and cohort effects and to assess their impacts on disease risk.The Bayesian APC model was further employed for robust and accurate projection of disease burden trends through 2038.Results Between 1993 and 2023,the age-standardized mortality rate for NR-CAVD in China remained at an extremely low level(2023:0.4/per 100,000),approximately 1/33 of the global rate(13/per 100,000),with a larger decrease(-29.5%vs.-4.6%).However,China's age-standardized incidence rate and age-standardized prevalence rate increased rapidly,with growth rates(74.5%and 84.8%,respectively)far exceeding the global increases(19.5%and 19.6%,respectively).APC model analysis showed that,in terms of age effect,both China and the global population experienced an increase in NR-CAVD mortality risk with age.In China,the incidence risk exhibited an accelerated increase in later years,while the prevalence risk increased linearly.In contrast,the global incidence and prevalence risks peaked in the elderly and then declined.The period effect was the key driver of the rising incidence and prevalence risks in China.The cohort effect showed a"U-shaped"change in the incidence risk in China,indicating a resurgence of risk in the new generation of elderly people.Projections until 2038 suggest that China will experience a modest increase in the ASMR of NR-CAVD by 7.84 per 100,000,while the ASIR and ASPR will rise by 13.62 per 100,000 and 7.60 per 100,000,respectively.In contrast,the global ASMR is projected to increase by 1.78 per 100,000,with the ASIR and ASPR declining by 14.52 per 100,000 and 12.31 per 100,000,respectively.The gap between China and global levels is expected to narrow gradually.Conclusion While the global burden of NR-CAVD is generally stable or declining,China faces a unique challenge with the continuous rapid increase in incidence and prevalence.Therefore,China's public health strategies should strengthen early screening in older adults and prioritize primary prevention focused on prehypertension,including earlier blood pressure management and lifestyle interventions,to curb the upward risk trajectory of NR-CAVD.
Keywords：Non-rheumatic calcific aortic valve diseaseAge-standardized mortality mateAge-standardized incidence rateAge-standardized prevalence rateDisease burdenAge-period-cohort modelTrend prediction
Publication Date：2025-12-20
Online Publishing Date：2026-01-04(First online date of this platform, not the publication date of the document)
Pages：9( 1141-1149 )