MON-284 - Global Trends in Premature Cardiovascular Mortality and Disability Attributable to High Body Mass Index, 1990-2023, with Projections to 2050: A Benchmarking Analysis

Background:
The global rise in high body mass index (BMI) has contributed substantially to the burden of noncommunicable diseases, with cardiovascular disease (CVD) representing the leading cause of premature mortality and disability worldwide. While the overall impact of high BMI on CVD is well-recognized, long-term global trends, regional disparities, of high BMI–attributable premature CVD burden remain underexplored.

Method:
We conducted a comprehensive analysis using the Global Burden of Disease 2023 study to assess trends in high BMI–attributable premature CVD burden among adults aged 30–69 years from 1990–2023. Population attributable fractions (PAFs) were derived using exposure distributions, relative risks, and the theoretical minimum risk exposure level. Deaths, DALYs, and YLLs were estimated for 204 countries and stratified by age, sex, year, and location. Estimated annual percentage change (EAPC) was calculated using log-linear regression, and projections up to 2050 were calculated by extrapolating the fitted regression model.

Results: Globally, high BMI–attributable premature CVD burden increased steadily from 1990–2023, with EAPCs of 1.999% per year (95% CI 1.870–2.127) for deaths, 2.136% (2.042–2.230) for DALYs, and 2.086% (1.986–2.186) for YLLs. Marked geographic heterogeneity was observed: EAPC in premature deaths was highest in South Asia (7.35%, 6.98–7.72), followed by Low SDI (5.55%, 5.38–5.72), Low-middle SDI (4.69%, 4.58–4.80), and Sub-Saharan Africa (4.61%, 4.45–4.77), while Central Europe, Eastern Europe, and Central Asia demonstrated declining trends (−0.68%, −1.00 to −0.36); High-income (0.09%, −0.09 to 0.27) and High SDI (0.08%, −0.07 to 0.23) were comparatively stable. Age-specific increases peaked at 50–54 years (Deaths 2.59%, 2.41–2.78; DALYs 2.62%, 2.44–2.81; YLLs 2.56%, 2.38–2.78) and were lowest at 65–69 years (Deaths 1.38%, 1.06–1.70; DALYs 1.49%, 1.20–1.79; YLLs 1.34%, 1.02–1.70). Trends were broadly similar by sex, with EAPCs for deaths of 2.03% (1.92–2.14) in males and 1.95% (1.80–2.11) in females, and for DALYs of 2.13% (2.05–2.20) in males and 2.15% (2.03–2.27) in females. Under continuation of observed trends, projected 2050 totals for ages 30–69 reached 1,374,962 deaths (95% CI 1,299,737–1,454,541), 52,610,684 DALYs (50,495,046–54,814,963), and 47,828,026 YLLs (45,778,700–49,969,093).

Conclusion: High BMI–attributable premature CVD mortality and disability have risen globally for over three decades, with the steepest growth concentrated in South Asia and lower-SDI settings and the most pronounced increases in midlife (50–54 years). If current trajectories persist, the premature CVD burden attributable to high BMI will escalate substantially by 2050, underscoring the urgency of scalable prevention policies and equitable risk-factor control strategies in rapidly transitioning regions.

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