Asthma is one of the most common chronic respiratory diseases. Understanding its prevalence, trend and risk factors is of great significance to take targeted preventive and control measures.

To analyze the prevalence, burden and trend of asthma in China from 1990 to 2019, and analyze the rank of asthma risk factors, so as to provide a basis for effective prevention and control of asthma in China.

Based on the Global Burden of Disease Database 2019 (GBD 2019), disability-adjusted life years (DALY), years of life lost (YLL), years lived with disability (YLD) and prevalence rates were used to analyse trends in the burden of disease by gender and age in China from 1990 to 2019. Changes in asthma risk factors were analyzed by population attributable faction (PAF) of standardized DALY rate and mortality rate.

In 2019, the age-standardized DALY rate, YLL rate and YLD rate for asthma in China was 102.81/ 100 000, 24.50/100 000 and 78.31/100 000, respectively, and the standardized prevalence rate was 1 974.16 /100 000, which was higher in all males than females, and higher in the 1-9 and ≥65 years old groups than the other groups. 1990-2019, the crude YLL rate was gradually decreasing in the ≥40 years old group, with DALY crude rates, YLD crude rates and prevalence all crossing over in the <65 years old group, but then showing a decreasing trend year on year. Secondary risk factors for asthma were ranked in order of tobacco use, high body mass index (BMI) and occupational hazards. Tobacco uses consistently ranked as the top risk factor for the burden of asthma, with high BMI rising to second place in 2019 and its PAF for mortality rising to first place.

From 1990 to 2019, there was an overall downward trend in per capita health loss in the asthma population, but the burden of asthma remained at a high level in the 1 to 9 and ≥65 years age groups. The burden of asthma disease was higher in men than women. The PAF of asthma-related risk factors has changed, with a relative decline in the importance of occupational hazards and the increasingly prominent impact of tobacco use and high BMI. The focus of asthma prevention and control can be focused on screening of high-risk groups (aged 1 to 9 years, aged≥65 years, males, tobacco use, with occupational exposure), smoking cessation education, weight control, monitoring and management of occupational settings.