Global burden of aortic aneurysm and its attributable risk factors from 1990 to 2021: an update from the GBD 2021

Aims: This study aimed to assess the global burden of aortic aneurysm (AA) and its attributable risk factors from 1990 to 2021. Methods: We used data from the Global Burden of Disease (GBD) 2021 Study to analysis disease burden of AA. We assessed trends in deaths and disability-adjusted life years (DALYs) related to AA across different demographic and regional groups, along with major attributable risk factors. Results: In 2021, AA accounted for an estimated 153,900 deaths and 3.1 million DALYs globally. Compared to previous decades, the age-standardized rates (ASRs) of deaths and DALYs have declined by 26.7% and 25.1%, respectively. In addition, the ASRs of both deaths and DALYs remained consistently higher in males than in females and increased with age. Most high socio-demographic index (SDI) regions showed substantial reductions in AA-related ASRs, except for high-income Asia Pacific. Smoking remained the leading contributor to AA-related DALYs among males (45.7%). In contrast, high systolic blood pressure (HSBP) emerged as the predominant risk factor among females in low- and low-middle SDI regions, surpassing smoking (17.0% vs. 8.8% and 17.8% vs. 11.7%, respectively). Conclusion: While ASR of deaths and DALYs from AA have declined since 1990, the total burden continues to rise. Despite advancements in AA prevention and treatment in high-income regions, the burden is increasing in lower income areas, highlighting the need for improved detection and treatment of AA. Preventive programs should strengthen their focus on smoking and HSBP control to reduce the burden of AA.