# Global trends and risk factors of aortic aneurysm mortality from 1990 to 2021: An analysis of the Global Burden of Disease Study 2021

## TL;DR

Aortic aneurysm deaths have increased globally since 1990, but death rates have declined in some regions, with notable differences by sex, age, and region.

## Contribution

This study provides updated global trends and risk factors for aortic aneurysm mortality using the latest GBD data from 1990 to 2021.

## Key findings

- Global aortic aneurysm deaths increased by 74.2% from 1990 to 2021, but age-standardized death rates declined in Europe and America.
- Men had nearly twice the death rate of women, though the gap has narrowed over time.
- Smoking was a major risk factor for men, while high blood pressure was more significant for women.

## Abstract

Aortic aneurysm (AA) is a life-threatening disease with significant global burden. However, population-based analyses of trends in AA mortality and its risk factors across sexes and world regions over time, based on up-to-date data, remain limited. This study aimed to conduct a comprehensive analysis of temporal and geographical trends in AA mortality and its risk factors over the past 3 decades, integrating age, sex, healthcare system, and socioeconomic factors using the latest data from the Global Burden of Disease (GBD) Study 2021.

Using the GBD Study 2021 data, we analyzed AA-related deaths, death rates, and the age-standardized death rates (ASDRs) per 100,000, along with risk factors. Trends from 1990 to 2021 were compared across global regions and countries by sociodemographic index, health systems, and income. We also examined the impact of age, sex, and risk factors over time.

In 2021, global AA-related deaths reached 153,927, a 74.2% increase from 1990. However, ASDR declined from 2.54 to 1.86 deaths per 100,000 people. AA mortality increased with age and varied across global regions, influenced by socioeconomic factors. ASDR declined by 24.8% in Europe and 47.4% in America, while Asia saw a 38.6% increase. Higher mortality persisted in regions with high income, advanced health system, and high sociodemographic index. In 2021, Japan had the highest total AA-related deaths (23,815), and Armenia had the highest ASDR (9.16 per 100,000). AA-related mortality demonstrated notable sex disparities. Men had nearly twice the ASDR of women, but the gap narrowed over time. The sex disparity also varied by age and region. Risk factors were also differed by sex and region. Smoking was the primary risk factor for men, while high systolic blood pressure was more significant for women. High body-mass index was one of the emerging risk factors. Notably, the relative contribution of these risk factors has shifted over time, reflecting changes in lifestyle, public health policies, and healthcare access.

AA-related mortality remains a global burden with regional and sex disparities, and is affected by socioeconomic factors. Smoking, hypertension, and obesity are key contributors, emphasizing the need for targeted prevention, screening, and healthcare access.