ORIGINAL RESEARCH article
Front. Epidemiol.
Sec. Cardiovascular Epidemiology
Epidemiological Study of Aortic Aneurysms Attributable to Smoking: A Comprehensive Analysis Based on GBD Data from 1990 to 2021
Provisionally accepted
- 1Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- 2Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China
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Abstract Objective This study aims to assess global burden of aortic aneurysm (AA) attributable to smoking from 1990 to 2021, addressing current gap in comprehensive literature on smoking-related AA burden and trends. Methods Using 2021 Global Burden of Disease (GBD) data, we analyzed burden of mortality and Disability-Adjusted Life Years (DALYs) attributable to smoking. Joinpoint regression identified key trend changes, while Age-Period-Cohort analysis and decomposition quantified impacts of aging, epidemiological shifts, and population. Results Between 1990 and 2021, global burden of AA attributable to smoking declined significantly. Estimated annual percent changes (EAPCs) were −2.17% (95% UI: − 2.29 to −2.05) for age-standardized mortality rate (ASMR) and −1.9% (95% UI: − 2.01 to −1.78) for age-standardized DALY rate (ASDR). Subgroup analysis revealed that burden was particularly high in men and older populations (aged 65 and above); with male ASDR at 23.66 (95% UI, 20.24–26.93), significantly higher than that of females 4.06 (95% UI, 3.29 – 4.91). An upward trend in global burden of AA attributable to smoking was most pronounced in Central Asia, with EAPCs for ASMR and ASDR at 2.44 (95% UI: 2.22–2.66) and 1.73 (95% UI: 1.53–1.94), respectively. In contrast, AA burden in Australasia showed largest decline. Conclusions This study provides a comprehensive assessment of global, regional, and national burden of aortic aneurysm attributable to smoking from 1990 to 2021 based on GBD 2021 data. Although global age-standardized mortality and DALY rates attributable to smoking-related aortic aneurysm have declined over the past three decades, substantial geographic and sex disparities remain. These findings reflect modeled population-level estimates derived from the GBD comparative risk assessment framework, which quantify the proportion of disease burden attributable to smoking rather than direct observational associations. Continued efforts to strengthen tobacco control policies, enhance early screening, and improve risk management are essential to further reduce the global burden of smoking-attributable aortic aneurysm.
Keywords: Aortic Aneurysm, Epidemiology, Global disease burden, Joinpoint regression analysis, Smoking
Received: 14 Mar 2025; Accepted: 19 Dec 2025.
Copyright: © 2025 Sun, Han, Hu, Zhang, Wang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xuejie Han
Dasheng Liu
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