Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction

FANG Lanxi; LIU Guanlin; YANG Yuhang; QI Zhi; DENG Qi; MENG Qiong

doi:10.16016/j.2097-0927.202506078

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Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction

Think Tank for Public Health | 更新时间：2025-09-28

- Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction
- Journal of Army Medical University Vol. 47, Issue 18, Pages: 2272-2280(2025)
- 作者机构：
  
  1.昆明医科大学：，公共卫生学院，（第一临床医学院），云南昆明
  2.昆明医科大学：，第一附属医院，（第一临床医学院），云南昆明
- 作者简介：
- 基金信息：
  
  the Regional Science Fund Program of National Natural Science Foundation of China(81960617)
- DOI：10.16016/j.2097-0927.202506078
  CLC： R195.4;R541.75
- Received：26 June 2025，
  
  Revised：2025-09-03，
  
  Accepted：08 September 2025，
  
  Published：30 September 2025
- 稿件说明：
移动端阅览
方岚希，刘冠林，杨宇航，等.1990—2021年全球、中国和日本心房颤动/心房扑动的疾病负担及其预测分析［J］.陆军军医大学学报，2025，47（18）：2272-2280.DOI：10.16016/j.2097-0927.202506078.

FANG LANXI，LIU GUANLIN，YANG YUHANG，et al.Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction［J］.J Army Med Univ，2025，47（18）：2272-2280.DOI：10.16016/j.2097-0927.202506078.
方岚希，刘冠林，杨宇航，等.1990—2021年全球、中国和日本心房颤动/心房扑动的疾病负担及其预测分析［J］.陆军军医大学学报，2025，47（18）：2272-2280.DOI：10.16016/j.2097-0927.202506078. DOI：

FANG LANXI，LIU GUANLIN，YANG YUHANG，et al.Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction［J］.J Army Med Univ，2025，47（18）：2272-2280.DOI：10.16016/j.2097-0927.202506078. DOI：

摘要

目的

分析1990—2021年全球、中国和日本心房颤动（atrial fibrillation，AF）/心房扑动（atrial flutter，AFL）的疾病负担、变化趋势及其差异，并对未来趋势进行预测，以期为卫生决策提供参考。

方法

基于2021年全球疾病负担数据库（Global Burden of Disease Study Database， GBD），提取全球、中国和日本不同性别的AF/AFL年龄标准化患病率（age-standardized prevalence rates，ASPR）和年龄标准化伤残调整寿命年率（age-standardized disability-adjusted life year rates，ASDALYR）数据，采用预计年百分比变化（estimated annual percentage change，EAPC）评估变化趋势，并运用Joinpoint回归模型和贝叶斯年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型进行分析和预测。

结果

1990—2021年，全球男性AF/AFL的ASPR和ASDALYR显著上升，EAPC分别为0.05（95%

：0.01~0.08）和0.09（95%

： 0.08~0.11）；而女性AF/AFL的ASPR和ASDALYR显著下降，EAPC分别为-0.11（95%

：-0.14~-0.07）和-0.10（95%

：-0.12~-0.07）。中国男性和女性AF/AFL的ASPR均上升，其中男性最显著，EAPC为0.77（95%

：0.65~0.88）；但ASDALYR呈性别分化，男性表现为上升（EAPC=0.40，95%

：0.30~0.49），而女性表现为下降（EAPC=-0.55，95%

：-0.67~-0.44）。日本男性和女性的ASPR和ASDALYR均呈现为持续下降，女性的ASPR和ASDALYR下降更显著，EAPC分别为-1.77 （95%

：-2.32~-1.22）和-1.73 （95%

：-2.11~-1.35）。Joinpoint分析显示，1990—2021年，针对AF/AFL的ASDALYR这一指标，中国男性和女性的平均年百分比变化（average annual percentage change，AAPC）分别为0.28%（

0.001）和-0.37%（

0.001）；而日本男性和女性的AAPC分别为-0.70%（

0.001）和-1.43%（

0.001）。根据BAPC模型，预计到2036年中国男性的ASDALYR将从2022年的91.45年/10万人增至101.11年/10万人，女性将从88.85年/10万人增至100.98年/10万人；日本男性的ASDALYR将从88.79年/10万人增至89.86年/10万人，女性将从41.13年/10万人降至39.67年/10万人，日本男性和女性的ASDALYR均为轻微波动。

结论

全球和中国AF/AFL的疾病负担仍在加重，需借鉴日本的生活习惯、健康政策等。对策建议相关政府机构通过政策—市场机制促进食品工业转型，开展全民健康管理相关活动，持续优化医疗卫生机构AF/AFL管理模式，以有效应对这一疾病负担变化。

Abstract

Objective

To analyze the disease burden

changing trends

and differences of atrial fibrillation (AF)/atrial flutter (AFL) globally and in China and Japan from 1990 to 2021

and to predict their future trends

aiming to provide references for health decision-making.

Methods

Based on the Global Burden of Disease Study Database 2021 (GBD 2021)

we extracted age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life year rate (ASDALYR) data for AF/AFL by sex globally

in China

and Japan. The estimated annual percentage change (EAPC) was used to assess the trends. Joinpoint regression analysis and the Bayesian age-period-cohort (BAPC) model were employed for trend analysis and prediction.

Results

From 1990 to 2021

the ASPR and ASDALYR for AF/AFL in males were increased significantly globally

with EAPC of 0.05 (95%

: 0.01~0.08) and 0.09 (95%

: 0.08~0.11)

respectively. Changes were significantly declined in females

with EAPC of -0.11(95%

: -0.14~-0.07)and -0.10(95%

:-0.12~-0.07). In China

the ASPR for AF/AFL were increased in both males and females

with those of males more notably (EAPC=0.77

95%

: 0.65~0.88). However

the ASDALYR for AF/AFL showed gender divergence

with an increase in males (EAPC=0.40

95%

: 0.30~0.49) while a decrease in females (EAPC=-0.55

95%

: -0.67~-0.44). In Japan

both the ASPR and ASDALYR for males and females showed continuous declines

and the reduction was more pronounced among females (ASPR EAPC=-1.77

95%

:-2.32~-1.22; ASDALYR EAPC=-1.73

95%

:-2.11~-1.35). Joinpoint regression analysis showed that from 1990 to 2021

for the ASDALYR of AF/AFL

the average annual percentage change (AAPC) was 0.28% (

0.001) for Chinese males and -0.37% (

0.001) for Chinese females

while the AAPC was -0.70% (

0.001) and -1.43% (

0.001) for Japanese males and females. BAPC model revealed that by 2036

the ASDALYR for Chinese males is predicted to increase from 91.45 per 100 000 in 2022 to 101.11 per 100 000

and for females is from 88.85 per 100 000 to 100.98 per 100 000. For Japanese males

the ASDALYR is projected to increase slightly from 88.79 to 89.86 per 100 000

while for females

it is projected decrease slightly from 41.13 to 39.67 per 100 000

indicating only minor fluctuations in the ASDALYR for both Japanese males and females.

Conclusion

The disease burden of AF/AFL continues to increase globally and in China. So

Japan’s lifestyle and health policies are worth considering

and more scientific and effective public health policies and clinical intervention strategies should be formulated and implemented. Countermeasure　The relevant government agencies should promote the transformation of the food industry through the policy-market mechanism

carry out activities related to national health management

and continuously optimize the AF/AFL management model of medical and health institutions to effectively cope with this disease burden change.

关键词

Keywords

references

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