Burden of aortic aneurysm in the United States and high sociodemographic index countries: a three-decade comparative analysis from the global burden of disease study

Background: Aortic aneurysm (AA) is a potentially fatal condition, especially in younger individuals. Despite its global burden, comparative trends in AA mortality and years of life lost (YLL) between the United States (U.S.) and countries with a high socio-demographic index (SDI) remain underexplored. Methods: We used Global Burden of Disease data (1990–2021) to extract age-standardized mortality rates (ASMRs) and age-standardized YLL rates (ASYRs) for AA in the U.S. and high SDI countries. Joinpoint regression was applied to calculate annual percent changes (APCs) and average annual percent changes (AAPCs), with 95% CI. Results: Between 1990 and 2021, the U.S. saw a 51% reduction in AA-related ASMRs, declining from 10.82 to 5.30 per 100 000 (AAPC: −2.31; 95% CI: −2.67 to −1.94). In contrast, high SDI countries experienced a 12.3% reduction, from 9.62 to 8.44 (AAPC: −0.45; 95% CI: −0.54 to −0.36). Similarly, U.S. ASYRs decreased by 49.3% (from 206.67 to 104.74; AAPC: −2.25; 95% CI: −2.59 to −1.91), whereas high SDI countries showed a 23.1% reduction (from 182.41 to 140.25; AAPC: −0.86; 95% CI: −0.95 to −0.77). Notably, AA mortality among high SDI females increased slightly, whereas U.S. trends declined across both sexes. The burden remained higher in males across both regions. Pairwise comparisons confirmed statistically significant differences in ASMRs and ASYRs between the U.S. and high SDI countries. Conclusion: The U.S. demonstrated greater progress in reducing AA-related mortality and YLL compared to high SDI countries. These findings underscore the need for renewed global attention and tailored strategies in AA prevention and management.

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