Global burden of atherosclerotic cardiovascular disease attributed to lifestyle and metabolic risks.

Atherosclerotic cardiovascular disease (ASCVD) continues to increase globally as the most common cardiovascular disease. Lifestyle and metabolic risks are major contributors to the increase in the burden of ASCVD. However, the epidemiological characterization of the burden of ASCVD due to lifestyle and metabolic risks has not been adequately documented. We analyzed data from the 2021 Global Burden of Disease Study to assess the disability-adjusted life years (DALYs) and age-standardized DALY rate (ASDR) attributed to ASCVD induced by lifestyle and metabolic risks. This study also analyzes temporal trends and inequalities in disease burden. Lifestyle and metabolic risks led to an increase in the DALYs and a decrease in the ASDR for ASCVD. High systolic blood pressure (SBP) was the primary contributor to the burden of ischemic heart disease (IHD) and ischemic stroke (IS), whereas high fasting plasma glucose (FPG) was the primary contributor to the burden of peripheral artery disease (PAD). High FPG and high body mass index (BMI) are primary risk factors that contribute to a more rapid increase in the burden of ASCVD. Over 32 years, high SDI regions reduced ASCVD burden linked to lifestyle and metabolic risks, while low SDI regions saw increases. ASCVD attributable to lifestyle and metabolic risks remains a major global public health concern. Although the burden of ASCVD caused by lifestyle and metabolic risks has improved in developed countries, developing countries still need to take effective measures to reduce the disease burden. Furthermore, while high SBP remains the leading contributor to the ASCVD burden, it is also crucial to recognize that high FPG and high BMI are becoming significant drivers of the growth in the ASCVD burden. This highlights the need for a paradigm shift in ASCVD prevention and control strategies-from single risk management to comprehensive metabolic network regulation.