The 30 Years Of Shifting In Indonesian Cardiovascular Burden -Analysis Of Global Burden Of Disease Study

Abstract

Abstract Importance: Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. Objective: To determine the national and province-level burden of CVD from 1990 to 2016 in China. Design, Setting, and Participants: This research used Global Burden Disease (GBD) 2019 Institute of Health Metrics (IHME) data to analyze CVD burden trends, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. Exposures: Residence in Indonesia Main Outcomes and Measures: Mortality, Incidence, prevalence, death, and DALYs of CVD. Results: CVD Deaths have doubled from 278 million in 1990 to 651 million in 2019. ALL CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (-69%) and congenital heart disease (CHD) (-37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka-Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD and PAD burdens were dominated by females. Conclusions: CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990-2019. Importantly, these data could provide reference points for policymakers, such as improving risk factor prevention and health care optimization.