What is the clinical evidence from this study?

Study design: Observational. Population: Hypertensive heart disease. Intervention: Time period (2019 vs 1990) vs. 1990 baseline. Primary outcome: Age-standardized death rate (ASDR) (EAPC -0.74, 95% CI -0.92 to -0.58).

April 27, 2022Open Access

Global, regional, and national burden of hypertensive heart disease during 1990–2019: an analysis of the global burden of disease study 2019

Key Result

Between 1990 and 2019, the global number of hypertensive heart disease cases increased to 19.60 million, while the age-standardized death rate decreased with an estimated annual percentage change of -0.74.

Study Design

Type

Observational

Structured PICO

Population

Global population with hypertensive heart disease (19.60 million cases in 2019, 7.82 million in 1990)

Outcome

Prevalence, death rates, disability adjusted life-years (DALY), and corresponding age-standardized rates of hypertensive heart disease

While the absolute number of hypertensive heart disease cases has increased globally over the past three decades, age-standardized mortality and DALY rates have declined.

Main Result

Effect estimate: EAPC -0.74 (95% CI -0.92 to -0.58)

Limitations

Actual data of HHD are not available in the GBD 2019 study
Absence of detailed information on the clinicopathological features of HHD, including severity stage and laboratory examination
Did not perform multiple linear regression due to the collinearity of the available socioeconomic factors and lack of other relevant covariates

Abstract

BACKGROUND: Hypertensive heart disease (HHD) is a major public health issue worldwide. We analyzed the global, regional, and national burden of HHD between the years 1990 and 2019 in relation to age, gender, and socioeconomic factors. METHODS: The prevalence and death rates, the disability adjusted life-years (DALY), and the corresponding age-standardized rates of HHD were extracted from the Global Burden of Disease study 2019. The epidemiological trends were evaluated by calculating the estimated annual percentage changes (EAPC) of the above variates. RESULTS: A total of 19.60 million HHD cases were documented in 2019 compared to 7.82 million in 1990, corresponding to an EAPC of 0.17. Contrarily, the global age-standardized death rate (ASDR) and age-standardized DALYs decreased with respective EAPCs of - 0.74 and - 1.02. HHD mostly occurred in people aged over 65. The disease burden of HHD varied considerably between countries, and univariate linear regression indicated that many socioeconomic variables had significantly negative correlations with age-standardized DALY rate. CONCLUSION: HHD cases have increased over the last three decades; however the mortality rate has declined. Multi-faceted improvements in health, education and income could help to alleviate the disease burden of HHD, specially in some regions with lower socio-demographic index and higher ASDR.

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