The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost

• Published in: PloS one 2023-04, Vol.18 (4), p.e0283879-e0283879
• Main Authors: Rodzlan Hasani, Wan Shakira, Muhamad, Nor Asiah, Hanis, Tengku Muhammad, Maamor, Nur Hasnah, Wee, Chen Xin, Omar, Mohd Azahadi, Ganapathy, Shubash Shander, Abdul Karim, Zulkarnain, Musa, Kamarul Imran
• Format: Article
• Language: English
• Subjects: Age; Analysis; Biology and Life Sciences; Cardiovascular disease; Cardiovascular Diseases; Cerebrovascular diseases; China; Citation management software; Diagnosis; Evaluation; Female; Health aspects; Heart diseases; Heterogeneity; Humans; Income; India; Ischemia; Life Expectancy; Male; Medical research; Medicine and Health Sciences; Medicine, Experimental; Mortality; Mortality, Premature; Myocardial Ischemia; People and Places; Poland; Premature mortality; Quality assessment; Research and Analysis Methods; Reviews; Risk factors; Serbia; Sex; Subgroups; Systematic review; World Health Organization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0283879

Premature mortality refers to deaths that occur before the expected age of death in a given population. Years of life lost (YLL) is a standard parameter that is frequently used to quantify some component of an "avoidable" mortality burden. To identify the studies on premature cardiovascular disease (CVD) mortality and synthesise their findings on YLL based on the regional area, main CVD types, sex, and study time. We conducted a systematic review of published CVD mortality studies that reported YLL as an indicator for premature mortality measurement. A literature search for eligible studies was conducted in five electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The synthesis of YLL was grouped into years of potential life lost (YPLL) and standard expected years of life lost (SEYLL) using descriptive analysis. These subgroups were further divided into WHO (World Health Organization) regions, study time, CVD type, and sex to reduce the effect of heterogeneity between studies. Forty studies met the inclusion criteria for this review. Of these, 17 studies reported premature CVD mortality using YPLL, and the remaining 23 studies calculated SEYLL. The selected studies represent all WHO regions except for the Eastern Mediterranean. The overall median YPLL and SEYLL rates per 100,000 population were 594.2 and 1357.0, respectively. The YPLL rate and SEYLL rate demonstrated low levels in high-income countries, including Switzerland, Belgium, Spain, Slovenia, the USA, and South Korea, and a high rate in middle-income countries (including Brazil, India, South Africa, and Serbia). Over the past three decades (1990-2022), there has been a slight increase in the YPLL rate and the SEYLL rate for overall CVD and ischemic heart disease but a slight decrease in the SEYLL rate for cerebrovascular disease. The SEYLL rate for overall CVD demonstrated a notable increase in the Western Pacific region, while the European region has experienced a decline and the American region has nearly reached a plateau. In regard to sex, the male showed a higher median YPLL rate and median SEYLL rate than the female, where the rate in males substantially increased after three decades. Estimates from both the YPLL and SEYLL indicators indicate that premature CVD mortality continues to be a major burden for middle-income countries. The patt