Spatiotemporal trends of cardiovascular disease burden attributable to ambient PM2.5 from 1990 to 2019: A global burden of disease study

There is little known about the global burden of CVD attributable to ambient PM2.5 (referred to as CVD burden hereinafter) and its secular trend across different regions and countries. We aimed to evaluate the spatiotemporal trends in CVD burden at the global, regional and national levels from 1990 to 2019. Data on CVD burden including mortality and disability adjusted of life years (DALYs) from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019. Cases, the age-standardized rate of mortality (ASMR) and DALYs (ASDR) were estimated by age, sex and sociodemographic index (SDI). Estimated annual percentage change (EAPC) was calculated to evaluate the temporal changing in ASDR and ASMR from 1990 to 2019. In 2019, 2.48 million deaths and 60.91 million DALYs of CVD were attributed to ambient PM2.5 globally. Most CVD burden occurred in males, elderly and the middle SDI region. At national level, Uzbekistan, Egypt, and Iraq had the highest ASMR and ASDR. Despite remarkable increase in number of DALYs and deaths of CVD worldwide from 1990 to 2019, we observed nonsignificant change in ASMR (EAPC: 0.06, 95 % CI: -0.01, 0.13) and slight increment in ASDR (EAPC: 0.30, 95 % CI: 0.23, 0.37). The EAPCs of ASMR and ASDR were negatively associated with SDI in 2019, while the low-middle SDI region exhibited the fastest growth of ASMR and ASDR with EAPCs of 3.25 (95 % CI: 3.14, 3.37) and 3.36 (95 % CI: 3.22, 3.49), respectively. In conclusion, the global CVD burden attributable to ambient PM2.5 has largely increased over the past three decades. The population growth, aging and SDI contributed to the heterogeneity of spatial and temporal distribution. Enforcing policy to improving air quality is required to halt the growing burden of PM2.5 on health.