Global, Regional, and National Burden of Pulmonary Arterial Hypertension, 1990-2021: a Systematic Analysis of the Global Burden of Disease Study 2021

Abstract

Aims Pulmonary arterial hypertension (PAH) is a severe pulmonary vascular disease with high mortality rates. This research aimed to examine the disease burden of PAH including prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021 across various age groups, sexes, and Socio-demographic Index (SDI) levels, at global, regional and national levels. Methods Data was collected from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2021, which established models to estimate the burden of PAH for 204 countries and territories from 1990 to 2021. Age-standardized rates for PAH prevalence, incidence, mortality, and DALYs were calculated. Joinpoint regression was used to assess temporal trends. The correlation between disease burden and socioeconomic development was analyzed. Results In 2021, the global age-standardized prevalence and incidence rates were 2.28 and 0.52 per 100,000 population, respectively. From 1990 to 2021, the age-standardized mortality rate decreased from 0.35 to 0.27 per 100,000, with an average annual trend of -0.82%. The age-standardized DALY rate decreased from 13.21 to 8.24 per 100,000 by -1.52%. Females exhibited a higher incidence rate but lower mortality and DALY rates. The burden of PAH distributed unequally, with regions possessing higher socioeconomic statuses exhibiting lower mortality and DALY rates. Such inequalities have been improved over past decades. Conclusions The decline in mortality and DALY rates of PAH indicates improvements in disease management and patient outcomes, while the health inequalities among different regions and countries persist. Improving survival and life quality, and global health equality are crucial for future progress.