Compared the Burden of Cardiovascular Disease attributable to Tobacco Exposure in China, Japan, USA and World

Abstract

Background Tobacco exposure (TE) is the major contributor of CVD mortality, but few published studies on CVD mortality attributable to TE analyzed the possible reasons underlying the long-term trends in China. Methods The mortality data in China, Japan, USA and World were obtained from GBD 2017. The joinpoint regression was used to assess the magnitude and direction of trends over time for CVD mortality, and the age-period-cohort method was used to analyze the temporal trends of CVD mortality by age, period, and cohort. Results There was a significant downward trend in age-standardized mortality rate (ASMR) of CVD attributable to smoking in four regions, but China has the smallest decline and the ASMR in China rose to the first rank in 2017. All the net drifts per year in four regions were negative, and the local drifts were below zero. The longitudinal age curves of the CVD mortality attributable to smoking increased in four regions and China had the largest increase. The period/cohort RRs indicated a decline, and China has the smallest decline. We further analyzed the trend of IHD and stroke, and found the morality, period/cohort RR of IHD in China was always in high level. Conclusions CVD mortality attributable to TE had declined in four regions, and it was at a high level in China. The proportion of IHD mortality attributable to TE had been similar to stroke, which had significantly changed the traditional cognition of CVD composition, and the control measure was not enough for IHD in China.