Hypertensive heart disease (HHD) is a major cause of global morbidity and mortality. Understanding its current burden among various countries and populations is crucial for formulating effective strategies for preventing and managing HHD. This study aimed to use the estimates from the Global Burden of Disease Study 2017 to describe the prevalence, mortality, and disability-adjusted life years for HHD for 195 countries and territories from 1990 to 2017. Worldwide, the age-standardized prevalence rate of HHD in 2017 was 217.9 (95% uncertainty interval [UI], 184.1–254.1) per 100 000 people, an increase of 7.4% (95% UI, 5.0–9.7) from 1990. The global age-standardized mortality and disability-adjusted life year rates of HHD were 12.3 (95% UI, 9.0–13.2) and 209.4 (95% UI, 160.5–226.3) per 100 000 people, a decrease of −19.3% (95% UI, −29.7 to −8.1) and −24.0% (95% UI, −31.0 to −13.7) from 1990, respectively. The global age-standardized prevalence rate of HHD was higher in females and increased with age. Between 1990 and 2017, Bolivia (51.3% [95% UI, 29.6–84.5]) and Maldives (32.3% [95% UI, 22.9–43.8]) showed the greatest increases in age-standardized prevalence rates. Generally, a negative association was found between the age-standardized disability-adjusted life year rates and Sociodemographic index at the regional and national levels. Our results suggest that HHD is a major public health challenge worldwide with an increasing prevalence rate over the past decades. Efforts to improve public awareness and management of high blood pressure and HHD, especially for vulnerable populations, were necessary.

Purpose: To estimate the incidence, death, disability-adjusted life years (DALYs) and attributable risk factors for respiratory infection and tuberculosis (RIT) in the US from 1990 to 2019. Methods: Following the methodology framework and analytical strategies used in the Global Burden of Disease Study 2019, the incidence, death, DALYs and risk factors of RIT were examined by age, gender and states from 1990 to 2019 in the US. All estimates were calculated as counts, age-standardized rates per 100,000 people and percentage change, with 95% confidence intervals (CIs). Results: In 2019, the age-standardized incidence, death and DALY rates per 100,000 people of RIT were 339,703 (95% CI 303,184 to 382,354), 13.6 (95% CI 12.2 to 14.4) and 384.9 (95% CI 330.6 to 458.6), respectively. Among RIT causes, upper respiratory infection accounted for the large majority of RIT age-standardized incidence rate, while lower respiratory infection constituted the highest proportion of RIT age-standardized death and DALY rates. The age-standardized incidence, death and DALY rates of RIT in 2019 and their temporal trends since 1990 varied widely across states and socio-demographic index. Among all attributable risk factors, smoking was the leading one for age-standardized RIT deaths in 2019, followed by low temperature and alcohol use (the attributable fractions were 17.7%, 15.3% and 6.9%, respectively). Conclusion: Our results suggest that RIT remained a major cause of health burden in the US, with large disparities persisting between US states. Intervention efforts for RIT hotspots, high-risk populations and modifiable risk factors are necessary.

Introduction: Metabolic risks including high body mass index, high fasting plasma glucose, high low-density lipoprotein cholesterol, high systolic blood pressure, kidney dysfunction and low bone mineral density, contribute heavy burden to the US health systems. We aimed to investigate the burden attributable to metabolic risks in the US from 1990 to 2019.Methods: Using methodology of Global Burden of Disease Study, the deaths and DALYs attributable to metabolic risks were analyzed by age, gender, states, Socio-demographic Index (SDI) and diseases from 1990 to 2019 in the US.Results: In 2019, the age-standardized death and DALY rates attributable to metabolic risks were 174.9 and 4738.7 per 100,000 people, accounting for 33.1% and 18.2% of death and DALY rates from all causes in the US, and there was a decrease by −32.5% and −21.2% in age-standardized death and DALY rates since 1990. The burden attributable to metabolic risks increased with age, and was higher in males than females. In addition, the burden varied widely across the states, generally in inverse proportion to the SDI levels, and the heaviest burden was observed in East and West South-Central of the US. Cardiovascular diseases carried heavy burden attributable to metabolic risks.Conclusion: The burden attributable to metabolic risks remained major public health concerns in the US. Prevention of metabolic risks should be a high priority in the US.

Behavioral risks including tobacco use, alcohol use, low physical activity and dietary risks had been proven to contribute to the pathological process in cardiovascular diseases (CVD). Herein the lethal effects attributable to behavioral risks on CVD in China were investigated. Data were obtained from the Global Burden of Disease Study 2019. Joinpoint regression analyses and age-period-cohort models were applied. In China, the total number of CVD deaths attributable to tobacco use, alcohol use, low physical activity and dietary risks in 2019 was 0.98, 0.19, 0.13 and 1.76 million, with an age-standardized rate of 51.2, 9.9, 8.9 and 101.9 per 100 000 people, respectively. Joinpoint analyses suggested a general favorable trend in age-standardized rate of attributable CVD mortality for tobacco use (average annual percent change [AAPC]: -0.9 %, P < 0.001), alcohol use (AAPC: -0.8 %, P < 0.001) and dietary risks (AAPC: -1.3 %, P < 0.001), but unchanged trend for low physical activity (AAPC: 0.2 %, P = 0.525) since 1990. Period effects suggested an improvement in attributable CVD mortality rate across the study period for alcohol use and dietary risks, but more favorable period trends were observed over the past 15 years for tobacco use and before the period 2000–2004 for low physical activity. The patterns for cohort effects differed markedly between men and women. In women, cohort effects revealed an inverted hook-shaped pattern for all these behavioral risks, with the highest risk in cohort born around 1915. In men, the improvement was mainly observed in cohorts born before 1980 for tobacco use and dietary risks, in cohorts born before 1965 for alcohol use, and in cohorts born between 1925 and 1955 for low physical activity. Behavioral risks, especially the dietary risks, brought out huge burden of CVD in China, and their trajectories differed along with time and genders. Much more priorities should be established to ameliorate the impact of behavioral risks on CVD in China.

Objectives: There is a shortage of reliable tools to evaluate general practitioners’ (GPs) ability to recognise and manage depression. The main aim of this study was to develop and validate a reliable tool for assessing the GPs’ ability to recognise and manage depression. Design: A cross-sectional survey incorporating the GPs’ ability to recognise and manage the depression assessment scale, the work was administered between July 2023 and June 2024. GPs’ ability to recognise and manage the depression assessment scale was developed in four phases: (1) item pool construction, (2) expert consultation, (3) exploratory factor analysis for further item reduction and to identify the factor structure of the revised scale and (4) confirmatory factor analyses to confirm the factors identified within the exploratory factor analysis. Setting: Primary healthcare in China. Participants: A total of 421 GPs participated in the study across phases 3 and 4. Phase 3 included 172 GPs, and phase 4 involved 249 GPs. They had been working in primary healthcare, with 44.42% having more than 10 years of experience. Of the participants, 57% were female. Results: The GPs’ ability to recognise and manage the depression assessment scale comprised two dimensions, with 24 items. Two factors explained 66.62% of the items’ variance through exploratory factor analysis. Confirmatory factor analysisconfirmedtwo dimensions of the scale and produced appropriate Goodness of Fit Indexes. Reliability was robust, with composite reliability coefficients exceeding 0.60, Cronbach’s alpha at 0.96 and a Spearman-Brown coefficient of 0.86. Conclusions: The newly developed scale is a reliable and valid tool for assessing GPs’ abilities to recognise and manage depression. It is suitable for large-scale surveys, particularly in underdeveloped regions, and can help identify gaps in knowledge. The scale results highlight areas where GPs’ skills are lacking, enabling the design of targeted continuing education programmes. It can also assess the effectiveness of depression training courses, providing a foundation for tailored interventions.