The Epidemiology of Aortic Aneurysms: Global and Regional Trends Between 1990 and 2021

ABSTRACT Background Aortic aneurysms (AAs) are major public health burden, contributing significantly to global mortality and disability. This study aims to investigate the underlying mechanisms of AA development to identify new therapeutic targets. Methods Mortality data, disability‐adjusted life‐years (DALYs), and their average annual percentage changes (AAPCs) from the Global Burden of Disease 2021 database were used to quantify the AA burden globally. The concentration and slope indices were used to delineate the inequality of the AA burden across the four regions, while the Age‐Period‐Cohort model was used to explain how biological and social factors affect the burden of AA. Results In 2021, AAs accounted for 3,107,762 DALYs globally, with an age‐standardized disability rate (ASDR) of 31.54 per 100,000 population and 153,927 deaths, yielding an age‐standardized mortality rate (ASMR) of 4.86 per 100,000 population. Overall, the burden decreased (AAPC: −1.04 for DALYs and −1.10 for deaths). The ASDR and age‐standardized mortality rate (ASMR) were higher in developed countries and territories, although these have decreased in recent years. The ASDR and ASMR for AAs exhibited negative correlations with period and cohort effects, while positive correlations with age were observed globally. Notably, we found that the post‐1960 birth cohorts, particularly those aged 30 to 45 in Asia, have faced a significant risk of AAs over the past 30 years. Conclusion Global mortality and DALYs due to AAs surged from 1992 to 2021, with higher rates observed in affluent countries and territories and for older populations, which subsequently decreased. The AA burden in Asia was highest in middle‐sociodemographic index countries and territories and among cohorts born after the 1960s, which warrants increased attention.