The Burden of Heart Failure due to Hypertensive Heart Disease.

OBJECTIVES

To analyze the global, regional, and national burden of heart failure (HF) attributable to hypertensive heart disease (HHD) from 1990 to 2021, with a focus on age and sex disparities, thereby providing multidimensional evidence to optimize hypertension control strategies and strengthen targeted HF prevention systems.

DESIGN

Cross-sectional trend analysis using the Global Burden of Disease 2021 database, with decomposition and inequality analyses.

SETTING AND

PARTICIPANTS

Not applicable.

METHODS

Using standardized methodologies from the Global Burden of Disease 2021 study, we assessed the burden of HHD-related HF across global, regional, and national levels, with stratification by age and sex. Joinpoint regression was employed to identify inflection points in temporal trends. Spearman correlation analysis evaluated the association between age-standardized rates and the sociodemographic index (SDI). Cross-national inequality analysis and decomposition methods were further applied.

RESULTS

Over the 32-year period, both the prevalence and years lived with disability rates of HHD-related HF increased globally. Low-SDI regions bore the highest absolute burden, whereas high-SDI countries exhibited the most pronounced relative growth in burden. Absolute and relative inequalities in HHD-related HF declined significantly. Population aging, population growth, and epidemiologic transitions collectively drove the rising burden.

CONCLUSIONS AND IMPLICATIONS: The global burden of HHD-related HF continues to rise, primarily fueled by population aging, though regional trends, and underlying drivers vary substantially. To address this challenge effectively, tailored prevention strategies should be implemented alongside global collaboration and equitable health care resource allocation, ensuring region-specific precision in HHD-related HF control.