Burden of cardiovascular disease from 1990 to 2017 in Henan Province, China

Figures & data

Table 1. Cases, prevalence, and percentage change between 1990 and 2017 for genders combined and separated for cardiovascular diseases in Henan

Groups	No. of cases per 100,000(95% UIs)			Age-Standardized Prevalence (95% UIs), per 100,000
	1990	2017	Percentage Change (%)	1990	2017	Percentage Change (%)
Both genders
Cardiovascular diseases	3923(3775–4085)	7546(7259–7869)	92.3	5668.4(5461.8–5905.2)	6325.9(6086.6–6578.4)	11.6
Rheumatic heart disease	672(636–708)	787(748–829)	17.2	758.0(718–798.1)	756(718.7–796.9)	−0.3
Ischemic heart disease	765(713–820)	1517(1415–1639)	98.4	1190.7(1110.1–1275.7)	1263.3(1174.2–1360.2)	6.1
Stroke	1150(1087–1215)	2693(2515–2884)	134.1	1641.6(1548.1–1736.2)	2211.9(2067–2363.5)	34.7
Hypertensive heart disease	171(143–201)	398(333–470)	133.0	285.7(239.3–339.2)	343.1(287.1–404.1)	20.1
Cardiomyopathy and myocarditis	10(8–13)	16(13–20)	61.3	14.1(11.3–16.9)	15.1(12.2–18.1)	7.4
Atrial fibrillation and flutter	220(188–254)	477(408–551)	116.7	379.6(324.3–437.3)	416(356.1–481)	9.6
Aortic aneurysm
Peripheral artery disease	891(766–1032)	1783(1546–2052)	100.1	1436.7(1239.8–1655.6)	1453(1259.8–1659.8)	1.1
Endocarditis	2(2–3)	4(3–4)	58.9	3.1(2.7–3.5)	3.7(3.2–4.1)	18.9
Non-rheumatic valvular heart disease	89(83–96)	198(185–211)	121.6	142.8(134.3–152.1)	167.3(157.4–177.2)	17.2
Other cardiovascular and circulatory diseases	284(230–338)	541(435–662)	90.6	379.2(307.1–455.2)	461.9(377.2–552.4)	21.8
Males
Cardiovascular diseases	1792(1719–1870)	3457(3309–3628)	92.9	5378.7(5159.5–5613.9)	6094.8(5828.8–6370.1)	13.3
Rheumatic heart disease	306(288–325)	338(319–358)	10.4	671.9(632.1–711)	661.2(623.7–700.1)	−1.6
Ischemic heart disease	356(329–384)	670(615–730)	88.2	1186.7(1099.9–1279.1)	1189.6(1095.4–1290.4)	0.2
Stroke	542(508–576)	1351(1250–1465)	149.4	1590.3(1481.1–1694.5)	2335.1(2160.5–2520.5)	46.8
Hypertensive heart disease	60(50–72)	142(116–170)	135.6	211.7(175.2–253)	257.8(212.2–307)	21.7
Cardiomyopathy and myocarditis	5(4–7)	8(6–10)	37.2	15.2(11.5–19.6)	14.2(10.7–17.9)	−6.5
Atrial fibrillation and flutter	96(82–111)	210(179–243)	117.9	375.7(319.3–432.8)	400.6(341.4–464.2)	6.6
Aortic aneurysm
Peripheral artery disease	381(328–444)	765(656–878)	100.8	1323(1149.5–1528.2)	1330.6(1143.3–1525)	0.6
Endocarditis	39(36–43)	2(2–2)	55.4	3.4(3–3.8)	4(3.5–4.5)	17.5
Non-rheumatic valvular heart disease	139(113–167)	88(80–95)	123.6	134.8(124.3–145.5)	159.4(147.5–171.6)	18.2
Other cardiovascular and circulatory diseases	3457(3309–3628)	256(207–316)	84.8	378.2(307.1–455.4)	452.7(367.1–550.2)	19.7
Females
Cardiovascular diseases	2131(2044–2217)	4089(3915–4266)	91.9	5942.5(5701.3–6190.1)	6539.6(6269.6–6808.7)	10.0
Rheumatic heart disease	365(344–388)	449(423–475)	22.9	847.4(798.8–899.5)	850(799.6–901.1)	0.3
Ischemic heart disease	409(380–439)	848(787–915)	107.4	1202.1(1118.6–1289.6)	1329.4(1233.1–1436.4)	10.6
Stroke	609(572–647)	1342(1245–1445)	120.5	1682.3(1581.7–1785.4)	2101.7(1953.8–2258.1)	24.9
Hypertensive heart disease	111(91–132)	256(215–303)	131.6	339.4(281.2–405.1)	412.4(346.6–488.2)	21.5
Cardiomyopathy and myocarditis	5(3–6)	9(7–11)	89.7	12.8(9.5–16.3)	16.3(12.2–20.7)	27.0
Atrial fibrillation and flutter	124(106–144)	267(228–310)	115.7	384.2(328.5–443.9)	430.7(367.8–500.2)	12.1
Aortic aneurysm
Peripheral artery disease	510(437–591)	1018(882–1173)	99.5	1541.2(1322.6–1773.8)	1561(1355.3–1794.1)	1.3
Endocarditis	1(1–1)	2(2–2)	63.1	2.8(2.5–3.1)	3.4(3–3.8)	21.1
Non-rheumatic valvular heart disease	50(46–54)	110(102–119)	120.0	150(139.4–161.6)	174.8(162.3–188)	16.6
Other cardiovascular and circulatory diseases	145(115–177)	284(226–349)	96.2	382.5(306–468.8)	470.2(378.4–568.7)	22.9

Note:UIs: Uncertainty Intervals.

Table 2. Deaths and age-standardized mortality rate and percentage change between 1990 and 2017 for genders combined and separated for cardiovascular diseases in Henan

Groups	Deaths, in Thousands (95% UIs)			Age-Standardized Mortality Rate (95% UIs), per 100,000
	1990	2017	Percentage Change (%)	1990	2017	Percentage Change (%)
Both genders
Cardiovascular diseases	181(169–194)	375(324–433)	106.9	355(331.6–379.1)	364.1(315.2–417.5)	2.6
Rheumatic heart disease	5(5–6)	3(2–3)	−45.0	8.7(7.8–9.7)	2.6(2.2–3)	−69.9
Ischemic heart disease	45(41–49)	162(140–187)	258.7	90.3(83.1–98)	161.8(140.4–185.5)	79.2
Stroke	108(101–117)	185(159–214)	71.0	206.9(191.3–222.7)	173.2(149.5–198.9)	−16.3
Hypertensive heart disease	19(10–22)	17(13–20)	−8.1	40(22.9–48.2)	17.7(12.7–20.9)	−55.8
Cardiomyopathy and myocarditis	1(1–1)	1(1–1)	31.4	1.2(1–1.5)	1.1(0.9–1.3)	−12.8
Atrial fibrillation and flutter	1(1–1)	3(3–4)	154.2	3.4(2.7–4)	3.6(3.1–4.2)	5.1
Aortic aneurysm	0(0–1)	1(1–1)	92.7	0.8(0.6–1.1)	0.8(0.7–1)	−2.2
Peripheral artery disease	0(0–0)	0(0–0)	378.3	0.1(0–0.1)	0.1(0.1–0.3)	115.4
Endocarditis	0(0–0)	0(0–0)	23.8	0.4(0.4–0.5)	0.3(0.3–0.4)	−20.0
Non-rheumatic valvular heart disease	0(0–1)	1(0–1)	57.7	0.7(0.5–1.1)	0.5(0.4–0.9)	−23.4
Other cardiovascular and circulatory diseases	1(1–2)	2(2–3)	83.5	2.4(1.9–3.1)	2.4(1.9–2.8)	−1.9
Males
Cardiovascular diseases	88(80–96)	199(162–240)	125.8	392.8(360.1–427.8)	423.9(348.6–506)	7.9
Rheumatic heart disease	2(2–2)	1(1–1)	−39.9	8(7–9)	2.6(2.1–3.1)	−67.8
Ischemic heart disease	24(21–27)	85(69–103)	258.0	105.1(94.6–118.7)	186.3(153.4–223.6)	77.2
Stroke	52(47–58)	101(82–121)	93.0	229.3(208.4–252.5)	206(168.9–245.5)	−10.2
Hypertensive heart disease	8(4–10)	8(6–10)	1.5	41.3(23.3–49.3)	19.5(14.1–23.9)	−52.7
Cardiomyopathy and myocarditis	0(0–1)	1(1–1)	44.1	1.4(1.1–2)	1.4(1.1–1.9)	0.8
Atrial fibrillation and flutter	0(0–0)	1(1–1)	200.4	2.4(1.7–3.1)	2.7(2.2–3.3)	14.1
Aortic aneurysm	0(0–0)	1(1–1)	106.2	1.3(0.9–1.8)	1.3(1–1.7)	1.5
Peripheral artery disease	0(0–0)	0(0–0)	471.6	0.1(0–0.2)	0.2(0.1–0.4)	148.8
Endocarditis	0(0–0)	0(0–0)	25.9	0.5(0.4–0.6)	0.4(0.4–0.5)	−17.7
Non-rheumatic valvular heart disease	0(0–0)	0(0–1)	62.9	0.8(0.6–1.4)	0.6(0.5–1.1)	−21.6
Other cardiovascular and circulatory diseases	1(1–1)	1(1–2)	107.3	2.6(1.9–3.6)	2.9(2.2–3.7)	11.0
Females
Cardiovascular diseases	93(84–103)	176(144–213)	89.0	325.3(294–358.5)	312(255.6–376.1)	−4.1
Rheumatic heart disease	3(3–3)	2(1–2)	−48.4	9.4(8.2–10.8)	2.7(2.1–3.2)	−71.8
Ischemic heart disease	21(19–24)	77(63–93)	259.5	78.3(68.9–87.7)	139.9(114.7–168.2)	78.7
Stroke	56(50–62)	84(68–103)	50.5	190.3(169–211.6)	145.2(118.2–176.8)	−23.7
Hypertensive heart disease	10(5–13)	9(5–11)	−15.7	38.5(20.6–49.3)	16.1(9.9–20.1)	−58.3
Cardiomyopathy and myocarditis	0(0–0)	0(0–0)	15.4	1.1(0.9–1.3)	0.8(0.6–0.9)	−25.9
Atrial fibrillation and flutter	1(1–1)	2(2–3)	138.2	4(2.9–4.8)	4.2(3.4–5)	4.0
Aortic aneurysm	0(0–0)	0(0–0)	64.4	0.5(0.3–0.7)	0.4(0.3–0.5)	−16.6
Peripheral artery disease	0(0–0)	0(0–0)	294.6	0.1(0–0.1)	0.1(0.1–0.2)	83.2
Endocarditis	0(0–0)	0(0–0)	20.6	0.3(0.3–0.4)	0.2(0.2–0.3)	−25.2
Non-rheumatic valvular heart disease	0(0–0)	0(0–0)	52.3	0.6(0.4–1)	0.4(0.3–0.8)	−26.1
Other cardiovascular and circulatory diseases	1(0–1)	1(1–1)	59.7	2.2(1.6–3)	1.9(1.5–2.4)	−14.4

Note: UIs: Uncertainty Intervals.

Figure 1. Tendency of cardiovascular diseases age-standardized mortality among residents in Henan, 1990–2017

Figure 2. Change trends of age-standardized mortality for main cardiovascular diseases in Henan, 1990–2017. (A) age-standardized mortality for both males and females. (B) age-standardized mortality for for males. (C) age-standardized mortality for females

Table 3. DALYs, YLDs, YLLs, and percentage change between 1990 and 2017 for genders combined and separated for cardiovascular diseases in Henan

Groups	1990 (per thousands)			2017 (per thousands)			Percentage Change (%)
	YLDs (95% UIs)	YLLs (95% UIs)	DALYs (95% UIs)	YLDs (95% UIs)	YLLs (95% UIs)	DALYs (95% UIs)	YLDs	YLLs	DALYs
Both genders
Cardiovascular diseases	361 (265–464)	3813 (3555–4079)	4174 (3893–4461)	792(577–1009)	6551 (5599–7639)	7343 (6407–8406)	119.3	71.8	75.9
Rheumatic heart disease	32 (21–47)	142 (129–156)	174 (156–195)	38(25–56)	54(46–63)	92 (76–111)	18.3	−62.1	−47.2
Ischemic heart disease	37 (25–51)	966 (883–1057)	1003 (922–1097)	72(50–99)	2735 (2335–3201)	2807 (2412–3284)	92.8	183.3	179.9
Stroke	236 (170–303)	2261 (2098–2431)	2496 (2310–2680)	568(407–726)	3348 (2841–3909)	3916 (3408–4472)	140.9	48.1	56.9
Hypertensive heart disease	14 (10–21)	312(174–371)	327 (187–386)	33(23–47)	260(194–309)	293 (225–344)	132.0	−16.8	−10.3
Cardiomyopathy and myocarditis	3 (2–4)	38(31–51)	41(33–54)	4(3–5)	32(27–39)	36(31–44)	47.3	−14.7	−10.8
Atrial fibrillation and flutter	18 (12–25)	15(12–18)	33(26–40)	38(25–53)	35(30–41)	73(60–88)	115.2	128.3	121.3
Aortic aneurysm	0 (0–0)	11(8–15)	11(8–15)	0(0–0)	19(15–24)	19(15–24)		66.3	66.3
Peripheral artery disease	5 (2–9)	0(0–1)	5(3–9)	8(4–14)	2(1–4)	10(5–17)	62.9	329.2	87.2
Endocarditis	0 (0–0)	15(12–20)	15(12–20)	0(0–0)	8(7–10)	8(7–10)	62.2	−46.6	−45.3
Non-rheumatic valvular heart disease	1 (1–2)	8(6–12)	9(7–13)	2(1–3)	10(8–16)	12(10–18)	106.8	26.5	36.2
Other cardiovascular and circulatory diseases	15 (10–22)	45(34–65)	60(47–82)	29(19–42)	48(39–56)	76(63–91)	89.0	6.8	27.5
Males
Cardiovascular diseases	158 (115–203)	2052(1861–2260)	2210 (2015–2421)	363(263–464)	3862 (3080–4732)	4224 (3452–5092)	129.6	88.2	91.2
Rheumatic heart disease	15 (10–22)	61(53–69)	75(65–86)	16(11–24)	25(20–31)	42(34–51)	11.0	−58.4	−44.8
Ischemic heart disease	17 (11–23)	571(507–650)	587(522–666)	30(21–42)	1632 (1307–2024)	1662 (1340–2054)	83.2	185.9	183.0
Stroke	102 (73–132)	1192(1071–1326)	1294 (1171–1427)	267(191–344)	1973 (1583–2414)	2240 (1834–2677)	160.6	65.5	73.0
Hypertensive heart disease	5 (3–8)	154(85–185)	160(89–189)	12(8–18)	143(101–177)	155 (113–191)	134.2	−7.4	−2.9
Cardiomyopathy and myocarditis	1 (1–2)	22(17–37)	23(19–38)	2(1–3)	22(17–28)	23(19–30)	47.0	−2.3	0.4
Atrial fibrillation and flutter	8 (5–11)	4(3–6)	12(9–16)	17(11–24)	12(9–15)	29(22–36)	116.0	168.8	135.1
Aortic aneurysm	0 (0–0)	8(6–12)	8(6–12)	0(0–0)	14(11–19)	14(11–19)		75.8	75.8
Peripheral artery disease	2 (1–4)	0(0–1)	2(1–4)	3(2–6)	1(1–3)	5(3–8)	70.7	420.9	110.0
Endocarditis	0 (0–0)	9(7–13)	9(7–13)	0(0–0)	5(4–7)	6(4–7)	59.2	−42.4	−41.4
Non-rheumatic valvular heart disease	0 (0–1)	4(3–8)	5(4–8)	1(1–1)	6(4–10)	7(5–11)	119.4	26.4	34.4
Other cardiovascular and circulatory diseases	7(5–11)	25(19–36)	33(26–44)	14(9–20)	29(21–36)	42(33–52)	83.3	14.4	30.1
Females
Cardiovascular diseases	203(148–260)	1761(1577–1953)	1965 (1777–2172)	430(312–550)	2689(2160–3286)	3119 (2599–3728)	111.4	52.7	58.7
Rheumatic heart disease	18(11–26)	81(71–94)	99(86–113)	22(14–32)	29(22–35)	50(40–62)	24.3	−64.9	−49.0
Ischemic heart disease	21(14–29)	395(347–446)	415(365–467)	42(28–57)	1103(878–1349)	1145 (927–1390)	100.6	179.5	175.6
Stroke	133(96–171)	1069(952–1186)	1202 (1080–1329)	301(216–384)	1375(1100–1692)	1677 (1401–2004)	125.8	28.7	39.5
Hypertensive heart disease	9(6–13)	158(82–203)	167(92–212)	21(15–30)	117(77–150)	138(98–171)	130.8	−26.0	−17.3
Cardiomyopathy and myocarditis	1(1–2)	16(12–21)	17(13–22)	2(1–3)	11(9–13)	13(11–15)	47.5	−32.0	−25.9
Atrial fibrillation and flutter	10(6–14)	11(8–13)	21(16–25)	21(14–29)	23(19–29)	44(36–53)	114.6	112.1	113.3
Aortic aneurysm	0(0–0)	3(2–4)	3(2–4)	0(0–0)	5(4–6)	5(4–6)		42.1	42.1
Peripheral artery disease	3(1–5)	0(0–0)	3(2–5)	5(2–8)	1(1–2)	5(3–9)	57.4	232.1	70.8
Endocarditis	0(0–0)	6(4–8)	6(4–8)	0(0–0)	3(2–3)	3(2–3)	65.6	−53.3	−51.6
Non-rheumatic valvular heart disease	1(0–1)	3(2–4)	4(3–5)	1(1–2)	4(3–6)	5(4–7)	98.2	26.6	38.6
Other cardiovascular and circulatory diseases	8(5–11)	20(12–33)	27(19–41)	15(10–22)	19(15–24)	34(27–42)	94.6	−3.0	24.5

Notes: DALYs: disability-adjusted life years, YLDs: years lived with disability, YLLs: years of life lost, UIs: Uncertainty Intervals.

Table 4. Age-standardized rates of DALYs, YLDs and YLLs per 100,000 and percentage change between 1990 and 2017 for genders combined and separated for cardiovascular diseases in Henan

Groups	1990				2017			Percentage Change(%)
	YLDs (95% UIs)	YLLs (95% UIs)		DALYs (95% UIs)	YLDs (95% UIs)	YLLs (95% UIs)	DALYs (95% UIs)	YLDs (95% UIs)	YLLs (95% UIs)	DALYs (95% UIs)
Both genders
Cardiovascular diseases	523.6(383.3–672.3)	5991.4(5586.2–6403.9)	6515(6095.1–6958.2)		667.8(489.1–850.3)	5590.2(4802.1–6486.5)	6257.9(5486.5–7146.9)	27.5(27.6–26.5)	−6.7(−14-1.3)	−3.9(−10-2.7)
Rheumatic heart disease	36.6(23.7–53.1)	196.7(178.2–215.9)	233.3(210.2–257.8)		36.8(24–53.9)	46.7(39.9–54.4)	83.5(68.4–101.1)	0.3(1.2–1.6)	−76.2(−77.6–74.8)	−64.2(−67.5–60.8)
Ischemic heart disease	58(39.7–79.8)	1514.3(1391.5–1648.4)	1572.2(1445.1–1711.2)		59.7(41.4–81.9)	2365.8(2024.7–2752.8)	2425.6(2090.2–2821.7)	3.1(4.4–2.7)	56.2(45.5–67)	54.3(44.6–64.9)
Stroke	341.4(245.5–436)	3550.1(3299.2–3814.5)	3891.5(3604.9–4165.5)		472.7(340.1–604.7)	2802.2(2384.9–3254.3)	3274.9(2852.9–3728)	38.5(38.5–38.7)	−21.1(−27.7–14.7)	−15.8(−20.9–10.5)
Hypertensive heart disease	23.8(16.1–33.6)	544.7(306.4–652.9)	568.5(326.2–673.7)		28.6(19.4–40.4)	230.5(170.1–273.2)	259.1(197.9–303.5)	20.1(20.5–20.3)	−57.7(−44.5–58.2)	−54.4(−39.3–54.9)
Cardiomyopathy and myocarditis	3.2(2.2–4.5)	45.6(37.2–61.4)	48.8(40.1–64.5)		3.7(2.5–5.2)	33.5(28.2–41)	37.2(31.8–44.8)	15.2(13.9–14.9)	−26.5(−24.1–33.2)	−23.7(−20.6–30.5)
Atrial fibrillation and flutter	29.9(20.3–41.8)	33.3(26.6–38.8)	63.3(51.6–76.4)		32.7(22–45.4)	35(29.9–40.8)	67.8(55.9–81)	9.4(8.3–8.4)	5(12.6–5.2)	7.1(8.4–6.1)
Aortic aneurysm	0(0–0)	16.8(12.4–21.6)	16.8(12.4–21.6)		0(0–0)	15.7(12.9–19.4)	15.7(12.9–19.4)	-	−6.3(3.9–10)	−6.3(3.9–10)
Peripheral artery disease	8.4(3.9–15.1)	0.9(0.5–1.9)	9.2(4.7–15.9)		6.8(3.1–12.5)	1.9(1.3–3.6)	8.7(4.7–14.7)	−18.1(−19.4–17.7)	112.2(178.1–93.1)	−5.8(0.6–7.5)
Endocarditis	0.2(0.2–0.3)	17.8(14–22.9)	18(14.2–23.1)		0.3(0.2–0.4)	7.6(6.5–8.9)	7.9(6.8–9.2)	18.7(20.1–17.2)	−57.2(−54–61.2)	−56.2(−52.5–60.1)
Non-rheumatic valvular heart disease	2(1.2–3.1)	11.5(9.2–17.9)	13.5(11.1–20)		2(1.2–3.1)	8.4(6.8–13.9)	10.5(8.5–16.1)	1(0–0.4)	−26.5(−26.2–22.3)	−22.4(−23.4–19.4)
Other cardiovascular and circulatory diseases	20.1(13.1–29)	59.8(46.8–85.1)	79.9(63.9–106.2)		24.4(16–35.7)	42.8(35–49.9)	67.2(55.2–80.1)	21.7(21.8–22.8)	−28.5(−25.3–41.3)	−15.9(−13.6–24.5)
Males
Cardiovascular diseases	475.8(348.2–612.7)	6808.1(6190.9–7451.9)	7283.9(6656.3–7936.2)		645.1(471.4–823.3)	6965.8(5603.7–8480.9)	7610.9(6255.4–9109.5)	35.6(35.4–34.4)	2.3(−9.5–13.8)	4.5(−6-14.8)
Rheumatic heart disease	32.4(21–47.3)	174(152.3–196.3)	206.4(181.1–233.5)		32(20.8–46.9)	46.7(37.7–57)	78.7(64.3–97.1)	−1.2(−1.2–0.8)	−73.1(−75.2–71)	−61.9(−64.5–58.4)
Ischemic heart disease	54.2(37.1–75.3)	1853.7(1650.2–2095.8)	1907.9(1706.9–2157.1)		53.5(37.2–73.8)	2979.8(2405.3–3670.5)	3033.3(2455.9–3723.2)	−1.2(0.2–2)	60.7(45.8–75.1)	59(43.9–72.6)
Stroke	308.4(220.4–393.2)	3986.8(3606.1–4409.6)	4295.3(3900.7–4729.5)		469.8(334.8–604.8)	3495(2827.1–4240.5)	3964.8(3265.9–4713)	52.3(52–53.8)	−12.3(−21.6–3.8)	−7.7(−16.3–0.3)
Hypertensive heart disease	17.8(11.7–25.8)	589.9(326.9–704.7)	607.8(343.4–719.6)		21.7(14.5–31.5)	271.2(193.3–335.1)	292.9(214.1–357.8)	21.8(24–22.4)	−54(−40.9–52.4)	−51.8(−37.7–50.3)
Cardiomyopathy and myocarditis	3.1(2.1–4.5)	51.6(40.9–81.5)	54.7(44.1–84.3)		3.6(2.5–5.2)	44.1(35–56.8)	47.7(38.5–60.9)	16(16.5–16)	−14.6(−14.3–30.2)	−12.9(−12.7–27.8)
Atrial fibrillation and flutter	29.9(19.7–41.9)	23.1(16.6–30.7)	52.9(41.1–67)		31.8(21.1–45)	26.8(21.8–33.2)	58.6(47–71.7)	6.5(7.1–7.5)	16.1(31.5–8.1)	10.6(14.5–7.1)
Aortic aneurysm	0(0–0)	25.4(17.7–34.8)	25.4(17.7–34.8)		0(0–0)	25.3(19.5–32.9)	25.3(19.5–32.9)	-	−0.4(10.6–5.5)	−0.4(10.6–5.5)
Peripheral artery disease	7.7(3.5–13.9)	1(0.4–2.8)	8.7(4.4–15.2)		6.3(2.9–11.7)	2.5(1.5–5.7)	8.8(4.9–15)	−18.2(−18.2–15.6)	149.6(283.5–99)	0.7(12.5–1.5)
Endocarditis	0.3(0.2–0.4)	21.5(16.1–28.8)	21.7(16.4–29.1)		0.3(0.2–0.4)	10.4(8.3–12.8)	10.7(8.6–13.1)	17.7(17.7–16.2)	−51.8(−48.5–55.6)	−50.9(−47.2–55)
Non-rheumatic valvular heart disease	1.9(1.1–3)	13.9(10.5–24.2)	15.8(12.2–26)		2(1.1–3)	10.5(7.9–18.8)	12.5(9.6–20.6)	2.6(2.2–0.1)	−24.4(−25.2–22.7)	−21.1(−21.2–20.6)
Other cardiovascular and circulatory diseases	20.1(13–29.3)	67.2(51.7–93.7)	87.3(69.4–114)		24(15.6–35)	53.5(39.8–66.6)	77.6(61.5–94.5)	19.6(20–19.4)	−20.3(−22.9–28.9)	−11.1(−11.4–17.1)
Females
Cardiovascular diseases	565.6(411.7–721.9)	5259.8(4727.3–5820.9)	5825.3(5272.9–6440.1)		688.6(502.2–881.1)	4345(3510.1–5300.6)	5033.6(4198.4–6008)	21.8(22–22.1)	−17.4(−25.7–8.9)	−13.6(−20.4–6.7)
Rheumatic heart disease	41.1(26.5–59.2)	220.4(191.8–253.9)	261.5(227.4–299.6)		41.5(26.8–60.6)	46.6(36.6–57.1)	88(69.2–108.6)	1(1.4–2.3)	−78.9(−80.9–77.5)	−66.3(−69.6–63.8)
Ischemic heart disease	61.1(42–84.6)	1200.1(1057.9–1346.5)	1261.2(1117.9–1411.8)		65.1(44.4–89.4)	1807.3(1446.2–2204.5)	1872.4(1525.5–2265.6)	6.5(5.8–5.7)	50.6(36.7–63.7)	48.5(36.5–60.5)
Stroke	370.6(267.5–475)	3171.5(2829.2–3518.1)	3542(3189.7–3916.9)		476(342.8–608.4)	2179.7(1745.5–2678.4)	2655.7(2221.4–3172.2)	28.5(28.2–28.1)	−31.3(−38.3–23.9)	−25(−30.4–19)
Hypertensive heart disease	28.2(19.2–39.5)	502.7(264.1–638.2)	530.9(292.4–668.7)		34.2(23.5–47.9)	193.8(125.6–247.2)	228(160.9–281.5)	21.5(22.6–21.1)	−61.5(−52.4–61.3)	−57.1(−45–57.9)
Cardiomyopathy and myocarditis	3.2(2.2–4.6)	39.3(29.8–50.9)	42.5(33–54.6)		3.7(2.4–5.4)	23.3(19.1–28.4)	27.1(22.7–32.5)	15.2(12.3–16.1)	−40.6(−35.8–44.3)	−36.3(−31.1–40.5)
Atrial fibrillation and flutter	30.1(20.2–42.3)	39.8(29.6–47.7)	70(55.4–84.7)		33.7(22.5–46.7)	41(33.2–50.1)	74.7(60.7–89.8)	11.8(11.6–10.5)	3(12–4.8)	6.8(9.7–6.1)
Aortic aneurysm	0(0–0)	9.3(6.3–11.8)	9.3(6.3–11.8)		0(0–0)	7.2(5.6–9)	7.2(5.6–9)	-	−22(−10.9–23.5)	−22(−10.9–23.5)
Peripheral artery disease	8.8(4.1–16)	0.8(0.3–1.5)	9.6(4.8–16.7)		7.3(3.3–13.2)	1.3(0.9–2.6)	8.6(4.6–14.7)	−17.5(−19.6–17.9)	68.1(179.9–73)	−10.5(−5.4–12.2)
Endocarditis	0.2(0.1–0.3)	14.1(10.1–19.5)	14.3(10.3–19.7)		0.3(0.2–0.4)	5(4–6.2)	5.3(4.3–6.5)	20.7(21.9–21.8)	−64.2(−60.3–68.3)	−62.9(−58.5–67.2)
Non-rheumatic valvular heart disease	2.1(1.2–3.3)	9.2(7.3–13.8)	11.2(9.1–15.9)		2.1(1.2–3.3)	6.5(4.9–10.7)	8.6(6.7–12.7)	0.4(0–0.4)	−29(−31.9–22.3)	−23.6(−27–20.5)
Other cardiovascular and circulatory diseases	20.2(13.1–29.3)	52.6(33.4–85.3)	72.7(51.9–106.7)		24.8(16.3–36.2)	33.2(26.2–41)	58(46.1–70.8)	22.8(24.3–23.2)	−36.9(−21.8–52)	−20.3(−11.2–33.6)

Notes: DALYs: disability-adjusted life years, YLDs: years lived with disability, YLLs: years of life lost, UIs: Uncertainty Intervals.

Figure 3. Percentage attribution of major risk factors of ischemic heart disease and stroke DALYs in Henan by gender in 1990 and 2017