Burden and trend of cardiovascular diseases among people under 20 years in China, Western Pacific region, and the world: An analysis of the global burden of disease study in 2019

OBJECTIVES: Cardiovascular disease (CVD) is a global public health concern, but its disease burden and trend have been poorly studied in people younger than 20 years. This study aimed to fill this gap by evaluating the CVD burden and trend in China, Western Pacific Region, and the world from 1990 to 2019. METHODS: We applied the 2019 Global Burden of Diseases (GBD) analytical tools to compare the incidence, mortality, and prevalence of CVD, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) among people younger than 20 years from 1990 to 2019 in China, the Western Pacific Region, and the world. The trends of disease burden between 1990 and 2019 evaluated using the average annual percent change (AAPC) and the 95% uncertainty interval (UI) were reported. RESULTS: Globally, in 2019, there were 2.37 (95% UI: 1.82 to 3.05) million incidence of CVD, 16.85 (95% UI: 12.56 to 22.03) million prevalence of CVD, and 74386.73 (95% UI: 64543.82 to 86310.24) deaths due to CVD among people under 20 years of age. The trends for DALYs decreased among children and adolescents in China, Western Pacific Region, and the world (AAPC = −4.29, 95% CI: −4.38% to −4.20%; AAPC = −3.37, 95% CI: −3.48% to −3.26%; AAPC = −2.17, 95% CI: −2.24% to −2.09%; p < 0.001, respectively) between 1990 and 2019. With the increase in age, the AAPC values of mortality, YLLs, and DALYs showed a notable downward trend. The AAPC values of mortality, YLLs, and DALYs in female patients were significantly greater than those in male patients. For all subtypes of CVD, the AAPC values showed a downward trend, with the largest reduction observed for stroke. From 1990 to 2019, a decline in the DALY rate for all CVD risk factors was observed, with a significant decrease in environmental/occupational risk factors. CONCLUSION: Our study shows a decline in the burden and trend of CVD among people younger than 20 years, which reflects the success in reducing disability, premature death, and the early incidence of CVD. More effective and targeted preventive policies and interventions aimed at mitigating preventable CVD burden and addressing risk factors from childhood are urgently needed.