Global, regional, and national burden of aortic aneurysm disease and its attributable risk factor, 1990–2021: a systematic analysis for the global burden of disease study 2021

This study aimed to evaluate the global, regional, and national burden of aortic aneurysms and their attributable risk factors from 1990 to 2021. Data from the global burden of disease 2021 study were used to analyze aortic aneurysm death numbers, age-standardized death rates (ASDR), and attributable risk factors across age, sex, region, and the Socio-demographic Index (SDI). Temporal trends were assessed by estimated annual percentage change (EAPC). Pearson correlation analysis evaluated the relationship between disease burden and covariates. In 2021, aortic aneurysm caused 153,927 deaths [95% uncertainty intervals (UI), 138,413-165,739], with an ASDR of 1.86 per 100,000 (95% UI 1.67-2.00). From 1990 to 2021, deaths increased by 74.2% (95% UI 56.4-94.0), while ASDR decreased by 26.8% (95% UI 18.0-34.6) with an EAPC of - 1.28% [95% confidence interval (CI), - 1.38 to - 1.18%]. Male ASDR was 2.25 times higher than females (95% UI 1.90-2.77) and correlated with SDI (R = 0.469, p < 0.001). The highest ASDR was in the High-income Asia Pacific (4.38 per 100,000; 95% UI 3.72-4.75). Smoking, the leading risk factor, accounted for 30.9% of ASDR (95% UI 26.3-35.8%). Projections estimate that deaths will rise to 174,611 (95% UI 163,289-185,933), with ASDR declining to 1.70 per 100,000 (95% UI 1.45-1.96) in 2030. Aortic aneurysm burden varies by age, sex, and region. Despite declining ASDR, it remains an emerging global public health issue driven by aging populations and shifting risk factors, requiring innovative prevention and healthcare strategies.