The burden of cardiovascular disease in children in Asian countries (1990-2021): Systematic analysis and projection of the burden of disease.

Background: Cardiovascular disease (CVD) is the leading global cause of death and health loss. The epidemiology and factors influencing CVD in children are unique, making it essential to first evaluate current and future trends to guide interventions and reduce the disease burden. Objective: To analyze the incidence, mortality, and disability-adjusted life years (DALY) of CVD in children aged 0-14 from 1990 to 2021, and explore global disease burden, risk factors, and trends over the next 30 years. The study focuses on China, Japan, South Korea, India, and Singapore to aid in developing targeted prevention and treatment strategies. Methods: Using data from the Global Burden of Disease Study (GBD) 1990-2021, we assessed age- and sex-specific morbidity, mortality, and DALY of CVD in Asian children aged 0-14 and computed the EAPC. We analyzed risk factors, specific causes, and projected prevalence trends through 2050 using the Bayesian Age-Period-Cohort (BAPC) model. Results: From 1990 to 2021, CVD incidence among Asian children aged 0-14 decreased by 8.03 % (95 % UI:13.63 to -4.02). Mortality saw a significant drop of 67.98 % (95 % UI:73.73 to -62.23), with the greatest decline in children aged 2-4, and the highest death rate in those under 1 year. Disability and mortality patterns were similar across gender, age, etiology, and overall trends. In 2021, South Asia had the highest rates of morbidity, mortality, and disability. Rates varied significantly, with Mongolia exhibiting the highest rate and Cyprus the lowest, showing a sixfold difference. Rheumatic heart disease (RHD) and intracerebral hemorrhage were the most critical diseases needed attention. Abnormal temperatures were identified as a risk factor associated with CVD outcomes in children. The burden of CVD is projected to increase in various regions and countries across Asia. Conclusion: The burden of CVD continues to challenge children aged 0-14 in Asia. Enhancing our understanding of pediatric CVD epidemiology, addressing risk factors, and reinforcing prevention and control measures are essential for reducing this burden.