Aging China's cardiac challenge: Projected growth of atrial arrhythmia cases and healthcare preparedness through 2045 — A global burden disease analysis

Atrial fibrillation/flutter (AF/AFL) poses significant risks of heart failure and stroke. From 1990 to 2021, China's AF/AFL cases surged from 3.20 to 10.78 million. Using Global Burden Disease (GBD) 2021 data and Bayesian age-period-cohort (BAPC) modeling, we analyzed trends and projected disease burden through 2045. Age-standardized incidence and prevalence rose by 5.4% and 14.5%, respectively, while mortality and disability-adjusted life year (DALY) rates declined by 12.2% and 3.8%. By 2045, prevalent cases may reach 23.04 million, with 1.93 million new cases, 220 000 deaths, and 4.21 million DALYs. Key risk factors include hypertension, smoking, high-sodium diet, and obesity. Sex disparities emerged, with females showing better mortality/DALY improvements than males. Population aging and metabolic risks will drive future burden. Targeted interventions (blood pressure control, smoking cessation, sodium reduction) and sex-/age-specific strategies are critical. Innovations in digital health (AI monitoring) and tiered healthcare networks could mitigate risks. Prioritizing China-specific prevention frameworks is essential to address this escalating public health challenge. Geriatr Gerontol Int 2025; 25: 1047-1057.