Changing patterns of heart failure in China from 1990 to 2021: a secondary analysis of the global burden of disease study 2021

AIMS: To assess the changing patterns of heart failure (HF) in China from 1990 to 2021, providing evidence for informed healthcare strategies. METHODS AND RESULTS: Data on prevalence, years lived with disability (YLDs), and their corresponding 95% uncertainty intervals (UI) were obtained from the Global Burden of Disease (GBD) Study 2021. The joinpoint regression model, the age-period-cohort model, and the autoregressive integrated moving average (ARIMA) model were utilized for more in-depth analysis. In 2021, 13 099 727 (95% UI, 11 320 895 to 15 376 467) individuals lived with HF and this illness accounted for 1 290 810 (95% UI, 865 894 to 1 775 731) YLDs in China. The burden of HF is more pronounced in males and the elderly, with ischaemic heart disease having become the leading cause since 2002. The age-standardized rates of prevalence and YLDs increased at average annual percentage changes of 0.23% (95% CI, 0.20 to 0.26) and 0.25% (95% CI, 0.23 to 0.27), respectively. The curve of local drift showed a downward trend with age. Both the period and cohort rate ratios have increased significantly over the last 30 years. By 2031, the age-standardized rates of prevalence will decrease to 678.69 (95% CI, 640.75 to 716.63), while the age-standardized rates of YLDs will increase to 69.19 (95% CI, 66.95 to 71.43). CONCLUSION: The burden and risk of HF in China remains a major concern. The implementation of comprehensive strategies should be taken into consideration, including strengthening the primary healthcare system, enhancing public health education, and promoting cardiac rehabilitation.