Aortic aneurysm and attributable risk factors from 1990 to 2050: insights from the global burden of disease study and machine learning-based projections

Aims: This study aimed to assess the global, regional, and national burden of aortic aneurysm (AA) and its attributable risk factors in 204 countries and territories from 1990 to 2050. Methods and results: Deaths and disability-adjusted life years (DALYs) were the primary metrics used to quantify the health burden of AA, evaluated by both total numbers and age-standardized rates. Stratified analyses examined demographic and geographic influences on disease burden from 1990 to 2050, incorporating sex, age, region, and the socio-demographic index (SDI). In 2021, AA accounted for 153 927 deaths and 3 107 762 DALYs worldwide. Between 1990 and 2021, the age-standardized rates of deaths and DALYs decreased by 26.69% and 25.10%, respectively. By 2050, the numbers of deaths and DALYs are projected to reach 210 202 and 4 332 444, respectively. During 2021–2050, the reductions in death and DALY rates are estimated at 37.63% and 25.51%, respectively. Considerable variability in burden was observed across regions and countries. Men and older individuals experienced a greater burden of AA, although the sex gap is narrowing. The association between SDI and AA burden was nonlinear and complex. Smoking, high systolic blood pressure, high body mass index, and diets low in fruits emerged as key modifiable risk factors requiring particular attention. Dried fruit intake is identified to be associated with lower AA risk by Mendelian randomization and meta-analysis. Conclusion: The burden of AA remains a significant public health concern. From 1990 to 2050, the total burden of AA increases, whereas the age-standardized mortality and DALY rates decline. Demographic and geographic disparities persist. Effective development and implementation of public health strategies are required to address the challenges posed by AA-related burdens.