Key result
Global HHD prevalence in older adults rises ~0.4% annually despite falling mortality and DALY rates.
Why the study?
Hypertensive heart disease poses a major public health challenge, but data on its burden and trends among older adults are scarce.
Observational
Yes
Effect estimate: AAPC 0.38 (95% CI 0.36, 0.41)
Despite decreases in mortality and DALY rates, the global prevalence of hypertensive heart disease among older adults has increased over the past three decades, highlighting the need for improved hypertension management.
Rising HHD prevalence in older adults despite falling mortality may reflect improved survival; leaves open drivers and optimal prevention strategies.
BACKGROUND: Hypertensive heart disease (HHD) poses a public health challenge, but data on its burden and trends among older adults are scarce. This study aimed to identify trends in the burden of HHD among older adults between 1990 and 2019 at the global, regional, and national levels. METHODS: Using the Global Burden of Diseases study 2019 data, we assessed HHD prevalence, death, and disability-adjusted life-year (DALY) rates for individuals aged 60-89 years at the global, regional, and national levels and estimated their average annual percentage changes (AAPCs) between 1990 and 2019 using joinpoint regression analysis. RESULTS: In 2019, there were 14.35 million HHD prevalent cases, 0.85 million deaths, and 14.56 million DALYs in older adults. Between 1990 and 2019, the prevalence of HHD increased globally {AAPC, 0.38 (95% confidence interval [CI], 0.36, 0.41)} with decreases observed in mortality (AAPC, -0.83 [95% CI, -0.99, -0.66]) and the DALY rate (AAPC, -1.03 [95% CI, -1.19, -0.87]). This overall global trend pattern was essentially maintained for sex, age group, and sociodemographic index (SDI) quintile except for non-significant changes in the prevalence of HHD in those aged 70-74 years and in the middle SDI quintile. Notably, males had a higher HHD prevalence rate. However, HHD-related mortality and the DALY rate were higher in females. The middle SDI quintile experienced the largest decreases in mortality and the DALY rate, with a non-significant decline in prevalence between 1990 and 2019. There were significant discrepancies in the HHD burden and its trends across regions and countries. CONCLUSIONS: In the past three decades, there has been an overall increasing trend in the prevalence of HHD among older adults worldwide despite decreasing trends in mortality and the DALY rate. Better management of hypertension, and prevention and control of HHD are needed in older adults.
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Yang et al. (2023) conducted an observational in Hypertensive heart disease. Hypertensive heart disease among older adults showed an increasing global prevalence between 1990 and 2019 (AAPC 0.38; 95% CI 0.36-0.41), alongside decreases in mortality and DALY rates.
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