Trends analysis of the global burden of hypertensive heart disease from 1990 to 2021: a population-based study

Hypertensive heart disease (HHD) majorly contributes to heart failure and mortality. Using the 2021 Global Burden of Disease Study (GBD) database, we investigated the epidemiology of HHD globally, regionally, and nationally between 1990 and 2021. This study aimed to assess trends and cross-country disparities in HHD burden between 1990 and 2021 and predict its progression until 2040.

Data on prevalence, disability-adjusted life years (DALYs) and their changes, and HHD risk factor attributions were extracted from the GBD 2021. The burden was analyzed across sociodemographic index (SDI) levels, sex, age groups, and 204 countries/territories.

The GBD 2021 included 12,505,435.66 prevalent and 25,462,184.71 DALY HHD cases. East Asia had the highest prevalence and DALYs, whereas the lowest SDI regions had the highest age-standardized rates (ASRs). Particularly among elderly females, who were the most affected group. Decomposition analysis revealed that population aging and growth primarily increased DALYs. Frontier analysis showed that the ASR of prevalence and DALYs declined as the SDI increased. Inequality analysis revealed that DALYs (per 100,000) decreased, and the prevalence increased from 1990 to 2021. Predictive analysis indicated that the ASR of DALYs would continuously decline, and prevalence ASR would initially decline and stabilize by 2040. In addition to high body mass index (BMI) and systolic blood pressure, low vegetable and fruit intake were critical risk factors.

Despite the global decline in the ASR of DALYs for HHD, the prevalence ASR continues to increase, particularly in high SDI regions. Tailored strategies based on regional and national heterogeneity are required to reduce the global HHD burden.