Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021

ObjectivesPulmonary arterial hypertension (PAH) is a severe and life-threatening condition. This study systematically examines the global epidemiology of PAH, focusing on trends in incidence, mortality, and disability-adjusted life years (DALYs) over the past 32 years to inform evidence-based policy...

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Main Authors: Zhenhao Liu, Liumei Mo, Wenjing Cao, Kui Wang, Hanxian Gong, Chen Li, Wei Pan, Jinqing He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1516365/full
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author Zhenhao Liu
Liumei Mo
Liumei Mo
Wenjing Cao
Wenjing Cao
Kui Wang
Hanxian Gong
Hanxian Gong
Chen Li
Wei Pan
Wei Pan
Jinqing He
author_facet Zhenhao Liu
Liumei Mo
Liumei Mo
Wenjing Cao
Wenjing Cao
Kui Wang
Hanxian Gong
Hanxian Gong
Chen Li
Wei Pan
Wei Pan
Jinqing He
author_sort Zhenhao Liu
collection DOAJ
description ObjectivesPulmonary arterial hypertension (PAH) is a severe and life-threatening condition. This study systematically examines the global epidemiology of PAH, focusing on trends in incidence, mortality, and disability-adjusted life years (DALYs) over the past 32 years to inform evidence-based policy and healthcare strategies.MethodsData from the Global Burden of Disease (GBD) 2021 study was used to analyze PAH incidence, mortality, and DALYs globally, regionally, and nationally from 1990 to 2021. Age-standardized incidence rate (ASIR), death rate (ASMR), disability-adjusted life years rate (ASDR) and estimated annual percentage change (EAPC) were assessed by age, gender, and socio-demographic index (SDI) quintiles. Hierarchical cluster analysis was performed to evaluate the temporal patterns of disease burden changes across GBD regions.ResultsGlobal PAH incident cases increased by 85.6%, from 23,301 in 1990 to 43,251 in 2021. ASIR increased slightly from 0.50 to 0.52 per 100,000 persons (EAPC 0.05%). From 1990 to 2021, PAH-related deaths increased from 14,842 to 22,021, though ASMR decreased (EAPC -0.57%). In 2021, PAH accounted for 642,104 DALYs, with ASDR showing a downward trend (EAPC -1.31%). Regions with low SDI exhibited the highest ASIR, while both ASMR and DALYs decreased across all SDI categories. Southern Sub-Saharan Africa had the highest incidence, while Central Asia saw the largest increases in mortality and DALYs.ConclusionOver the past 32 years, global ASMR and ASDR for PAH have decreased, while ASIR showed a modest increase. Persistent imbalances in treatment and outcomes remain in certain regions. Enhanced prevention and comprehensive management strategies are needed to diminish the global PAH burden and improve health equity.
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spelling doaj-art-41ce0e68a93d4203ac38ea015cd1fb402025-08-20T03:05:45ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15163651516365Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021Zhenhao Liu0Liumei Mo1Liumei Mo2Wenjing Cao3Wenjing Cao4Kui Wang5Hanxian Gong6Hanxian Gong7Chen Li8Wei Pan9Wei Pan10Jinqing He11Department of Cardiovascular Medicine, Pingxiang People's Hospital, Jiangxi, ChinaDepartment of Cardiology, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Geriatrics, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Cardiology, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Geriatrics, Foshan Women and Children Hospital, Foshan, ChinaThe First Clinical Medical College, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Cardiology, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Geriatrics, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Cardiovascular Medicine, Pingxiang People's Hospital, Jiangxi, ChinaDepartment of Cardiology, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Geriatrics, Foshan Women and Children Hospital, Foshan, ChinaDepartment of Cardiology, Ganzhou People's Hospital, Ganzhou, ChinaObjectivesPulmonary arterial hypertension (PAH) is a severe and life-threatening condition. This study systematically examines the global epidemiology of PAH, focusing on trends in incidence, mortality, and disability-adjusted life years (DALYs) over the past 32 years to inform evidence-based policy and healthcare strategies.MethodsData from the Global Burden of Disease (GBD) 2021 study was used to analyze PAH incidence, mortality, and DALYs globally, regionally, and nationally from 1990 to 2021. Age-standardized incidence rate (ASIR), death rate (ASMR), disability-adjusted life years rate (ASDR) and estimated annual percentage change (EAPC) were assessed by age, gender, and socio-demographic index (SDI) quintiles. Hierarchical cluster analysis was performed to evaluate the temporal patterns of disease burden changes across GBD regions.ResultsGlobal PAH incident cases increased by 85.6%, from 23,301 in 1990 to 43,251 in 2021. ASIR increased slightly from 0.50 to 0.52 per 100,000 persons (EAPC 0.05%). From 1990 to 2021, PAH-related deaths increased from 14,842 to 22,021, though ASMR decreased (EAPC -0.57%). In 2021, PAH accounted for 642,104 DALYs, with ASDR showing a downward trend (EAPC -1.31%). Regions with low SDI exhibited the highest ASIR, while both ASMR and DALYs decreased across all SDI categories. Southern Sub-Saharan Africa had the highest incidence, while Central Asia saw the largest increases in mortality and DALYs.ConclusionOver the past 32 years, global ASMR and ASDR for PAH have decreased, while ASIR showed a modest increase. Persistent imbalances in treatment and outcomes remain in certain regions. Enhanced prevention and comprehensive management strategies are needed to diminish the global PAH burden and improve health equity.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1516365/fullpulmonary arterial hypertensiondisease burdendisability-adjusted life yearsincidencedeath
spellingShingle Zhenhao Liu
Liumei Mo
Liumei Mo
Wenjing Cao
Wenjing Cao
Kui Wang
Hanxian Gong
Hanxian Gong
Chen Li
Wei Pan
Wei Pan
Jinqing He
Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
Frontiers in Public Health
pulmonary arterial hypertension
disease burden
disability-adjusted life years
incidence
death
title Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
title_full Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
title_fullStr Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
title_full_unstemmed Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
title_short Global, regional, and national trends in pulmonary arterial hypertension burden, 1990–2021: findings from the global burden of disease study 2021
title_sort global regional and national trends in pulmonary arterial hypertension burden 1990 2021 findings from the global burden of disease study 2021
topic pulmonary arterial hypertension
disease burden
disability-adjusted life years
incidence
death
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1516365/full
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