Global, Regional, and National Burden and Trends of Hypertensive Heart Disease Among Women of Childbearing Age from 1992 to 2021

Background: Hypertensive heart disease (HHD) is an important contributor to cardiovascular morbidity among women of childbearing age (WCBA), yet long-term global trends in this population remain insufficiently characterized. We aimed to describe the prevalence, mortality, and disability-adjusted life years (DALYs) of HHD among WCBA at global, regional, and national levels and to assess temporal patterns from 1992 to 2021. Methods: Data were obtained from the Global Burden of Disease (GBD) 2021 study. We estimated numbers and age-standardized rates of prevalence, mortality, and DALYs for women aged 15– 49 years. An age-period-cohort (APC) model was applied to disentangle age, period, and cohort effects on mortality trends. Results: From 1992 to 2021, the global burden of HHD among WCBA exhibited a divergent trend: while the prevalence rate increased steadily from 20.09% to 27.94%, mortality and DALY rates generally declined. In 2021, significant regional disparities existed, with the middle-SDI region recording the highest prevalence, whereas the high-middle SDI region achieved the lowest mortality and DALY rates. APC analyses for mortality further clarified these shifts: period-effect risks declined across most SDI groups but notably increased in high-SDI countries. Similarly, while cohort-effect risks significantly reduced in most regions, high-SDI countries exhibited a distinct pattern of an initial risk rise followed by a subsequent decline. Conclusion: Global HHD trends among WCBA are characterized by rising prevalence alongside declining mortality and DALY rates. Marked disparities persisted across SDI regions, with the highest prevalence in middle-SDI settings and more variable mortality patterns in high-SDI settings.