Global pattern, trend, and cross-country inequality of cardiovascular diseases caused by hypertension from 1990 to 2021, with projection from 2022 to 2060

Background: Cardiovascular diseases caused by hypertension pose a serious threat to global health. This study analyzed trends and future projections of hypertension-related cardiovascular diseases burden using Global Burden of Disease 2021 data. Methods: We estimated mortality and disability-adjusted life years (DALYs) via DisMod-MR 2.1, analyzed regional disparities by socio-demographic index (SDI), and projected trends to 2060 using the Bayesian age-period-cohort model. Health inequalities were evaluated via the slope index of inequality and concentration index. Results: Globally, the number of DALYs and deaths due to cardiovascular diseases caused by hypertension increased in 2021, reaching 214,518,341 (95% uncertainty interval [UI]: 180,418,055-247,570,720) and 10,376,441 (95% UI: 8784,052-12,032,762) respectively, while the age-standardized DALYs rate (ASDR) and age-standardized mortality rate (ASMR) decreased. In high SDI regions, the number of DALYs and deaths decreased, while in the remaining regions, they increased. However, the ASDR and ASMR in all SDI regions decreased. In 21 major regions, the number of DALYs and deaths increased. East Asia had the highest values, and Oceania had the lowest. Only in Southern Sub-Saharan Africa did the ASDR and ASMR increase. Regarding age, DALYs rates increased with age from 15-74 years, and mortality increased with age from 15-84 years, and decreased after 75 and 85 years, respectively. It is predicted that DALYs rates and mortality continue to decline and stabilize by 2060. Conclusion: The burden of cardiovascular diseases caused by hypertension varies markedly across the globe, with declining rates in high SDI regions but rising trends in low and low-middle SDI regions. These findings indicate growing inequalities and the need for region-specific interventions.