AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Evolving Trends in Aortic Aneurysm Risk Factors in the Ten Most Populous Countries from 1990 to 2021 and Forecasts Till 2050: A Global Burden of Disease (GBD) Study
By Farooq M, Sajid MM, Iqbal M et al.
Background: Aortic aneurysm (AA) is a major cause of cardiovascular mortality. Although global mortality has declined, country-specific and risk-related trends remain poorly defined. Research Question: We hypothesized that AA mortality has declined globally but increased in several highly populated countries due to modifiable risk factors such as smoking, high blood pressure, and elevated body mass index. Methods: This observational study used data from the Global Burden of Disease 2021 study. We analyzed age-standardized mortality rates (ASMRs) for AA from 1990 to 2021 across the ten most populous countries based on 2023 population estimates. Trends for mortality related to smoking, high blood pressure, and high body mass index were assessed globally and by sex. Joinpoint regression analysis was performed to determine estimated annual percentage change and 95% confidence intervals. Results: Global ASMR declined from 2.54 to 1.86 per 100,000 (AAPC: -0.99; 95% CI: -1.01 to -0.95). The rate declined from 3.87 to 2.57 in males (AAPC: –1.31) and from 1.58 to 1.28 in females (AAPC: -0.65). Among the ten countries analyzed, seven showed an increasing ASMR trend (Bangladesh, Brazil, China, India, Indonesia, Pakistan, and Russia) led by Russia, while three showed a decreasing trend (the United States, Nigeria, and Ethiopia) led by Ethiopia. Smoking-related ASMR dropped globally from 0.98 to 0.56 (AAPC: -1.80). Males had consistently higher rates, though females experienced a steeper decline (AAPC: -2.12). Russia showed the highest increase (AAPC: 2.25). High blood pressure (BP)–associated ASMR fell from 0.52 to 0.32 (AAPC: -1.53), with the United States showing a strong decline (AAPC: -3.93). High body mass index–related ASMR declined from 0.18 to 0.14 globally (AAPC: -0.90), with India having the steepest rise (AAPC: 4.07). Compared to the ASMRs in 2021, forecasts project a decline in overall global ASMRs (1.38) by 2030 but an increase in ASMRs among all ten countries analyzed. The decline was most pronounced in smoking-related ASMRs (0.25), led by the U.S. (-0.04). India led the decline in BMI-related ASMRs (0.039), while China led in high blood pressure-related ASMRs (0.054). Conclusion: While global AA mortality has decreased, rising trends in several high-population countries driven by modifiable risk factors underscore the urgent need for region-specific public health strategies.