Due to population growth and aging, disability-adjusted life years (DALYs) will continue to rise, although the projected decline in DALYs due to modifiable cardiovascular risk factors suggest improved management of cardiovascular diseases, according to a study published July 14 in JACC.

Using mortality data from the Global Burden of Disease (GBD) 2021 study and adhering to the Guidelines for Accurate and Transparent Health Estimates Reporting statement, Bryan Chong, MBBS, et al., conducted a study to forecast the burden associated with modifiable cardiovascular risk factors including systolic blood pressure (SBP), high fasting plasma glucose, high BMI, high LDL-C and tobacco use, from 2025 to 2050. Trends across GBD super-regions, sex, sociodemographic index and age groups were examined.

The authors conducted a forecast analysis of crude and age-standardized cardiovascular deaths and DALYs from 2025 to 2050, and results showed that "although age-standardized DALY rates will fall across all cardiovascular risk factors from 2025 to 2050, overall crude DALYs associated with cardiovascular risk factors are projected to rise within the same period." Furthermore, high SBP (rising by 99 million DALYs; 44% increase), and high BMI (increasing by 44 million DALYs; 88% increase) will have the greatest rise in crude DALYs from 2025 to 2050.

By 2050, the vast majority of DALYs associated with risk factors will be attributed to high SBP (325 million DALYs), followed by high LDL-C (122 million DALYs) and high BMI, high fasting plasma glucose and tobacco use. Men will continue to bear a larger proportion of cardiovascular disease-related DALYs across all risk factors in 2050.

"The age-standardized DALY burden of modifiable [cardiovascular] risk factors is projected to fall from 2025 to 2050, a reflection of the effectiveness of current disease management strategies," write the authors. "…the net effect of these preventative efforts will be offset by the growing, aging populations with anticipated increase in crude DALYs attributed to [cardiovascular] risk factors. High SBP, which will remain the leading driver of DALYs, and high BMI have been identified to be the fastest-growing risk factors."

"This approach draws attention to the combined challenges of risk factor control," write Jeremy Schwartz, et al., in an accompanying editorial comment. "Their study stratifies trends in risk factor burdens by sex, age and sociodemographic index – a composite indicator inclusive of economy, education, and fertility rate – offering actionable insights to improve population health. These findings can guide policymakers and system planners in prioritizing interventions specific to age, sex and region."