Burden of aortic aneurysm and its attributable risk factors in 204 countries and territories, 1990-2021 results from the Global Burden of Disease Study 2021

ObjectiveTo assess the global, regional, and national burden of aortic aneurysm (AA) and its risk factor attributions by age, sex, and sociodemographic index (SDI) from 1990 to 2021. DesignCross-sectional analysis of epidemiological trends using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 data. Main outcome measuresAge-standardised mortality rate (ASMR), disability-adjusted life years (DALYs), and attributable risk factors for AA. MethodsAge-standardised rates and absolute counts of deaths and DALYs were calculated with 95% uncertainty intervals (UIs). Trends were analysed using annual percentage changes. Risk factor contributions were estimated via comparative risk assessment. Data sourcesNationally representative mortality and morbidity data from 204 countries and territories, collated in the GBD 2021 study (1990-2021). ResultsIn 2021, AA caused 153 900 deaths (ASMR: 1.9 per million, 26.7% decline since 1990) and 3.1 million DALYs (age-standardised DALY rate: 36.5 per 100 000, 25.1% decline since 1990).Armenia had the highest ASMR (9.2 per million) and DALY rate (192.8 per 100 000), while Saudi Arabia had the lowest (0.2 per million and 5.1 per 100 000). DALY rates peaked at 85-89 years in men (declining thereafter) but increased continuously with age in women (highest in [≥]95 years). Age-standardised DALY rates exhibited a reversed V-shaped relationship with SDI, with higher burdens in low-to-middle SDI regions. Smoking (37.3%), hypertension (17.1%), and high BMI (8%) accounted for 62.4% of AA-related DALYs. ConclusionsAA remains a critical public health challenge, disproportionately affecting low-SDI regions. Targeted interventions addressing smoking cessation, blood pressure control, and BMI regulation are essential to mitigate the burden. Policymakers should prioritise these strategies, particularly in socioeconomically disadvantaged populations.