# Burden and trend of cardiovascular diseases in youths aged 0–19 years in China, Asia, and the world, with forecasts to 2036: a systematic analysis of the global burden of disease study 2021

## TL;DR

This study analyzes the global, Asian, and Chinese trends in cardiovascular disease burden among children and adolescents from 1990 to 2021 and forecasts future trends up to 2036.

## Contribution

The study provides a systematic analysis of CVD trends in youths and forecasts future burden using GBD 2021 data and ARIMA modeling.

## Key findings

- Global CVD DALY rates in youths declined significantly from 1990 to 2021.
- Rheumatic heart disease is the most prominent CVD subtype globally.
- Non-optimal temperatures are the primary risk factor for CVD-related DALYs.

## Abstract

To combat the harmful impacts of cardiovascular diseases (CVDs) on public health, it is crucial to understand the epidemiologic features and disease burden. The study aims to identify the trends of CVDs burden in youths aged 0–19 years from 1990 to 2021 across the global, Asian, and Chinese contexts to inform more effective strategies and actions.

The data from the Global Burden of Diseases and Risk Factors Study (GBD) 2021 were analyzed, stratified by sex, age, the socio-demographic index (SDI) regions, disease subtypes, respectively. We also employed the Auto-Regressive Integrated Moving Average (ARIMA) to predict the future burden of CVDs up to 2036.

In 2021, DALY rate of CVDs among children and adolescents were 303.140 (268.480–343.800) globally, 268.730 (242.730–298.350) in Asia and 148.800 (126.510–173.620) in China. It exhibited significant declined trends from 1990 to 2021, with average annual percentage changes (AAPCs) of −2.447, −2.665, and −4.379, respectively (all p < 0.001). Compared with males, females had relatively higher prevalence of CVDs globally (797.060 vs. 791.140 per 100,000). Rheumatic heart disease served as the most prominent subtype across the world. Non-optimal temperatures emerged as the primary risk factor for CVDs-related disability-adjusted life years (DALYs). The CVDs incidence rate is predicted to rise to 108.861 per 100,000 globally, while the rate in Asia remains steady and decreases in China in 2036.

A substantial global burden of CVDs in youths aged 0–19 years remains the pressing public health issue in 2021. The burden of overall and type-specific CVDs varies by age, sex, SDI, regions and countries. Current and future challenges in CVDs prevention for youngsters implied by the epidemiologic features are highlighted in this study.