Key result
Global COPD-associated heart failure cases rise ~1.4-fold since 1990, exceeding 3.6 million in 2021.
Why the study?
Comprehensive global evaluations of the burden of chronic obstructive pulmonary disease-associated heart failure remain limited.
Observational (n=3,613,136)
Effect estimate: AAPC 0.07 (95% CI 0.03-0.12)
Absolute Event Rate: 43.24% vs 41.93%
The global burden of COPD-associated heart failure has grown significantly from 1990 to 2021 and is projected to continue rising through 2050, highlighting an urgent need for coordinated international prevention and management strategies.
Rising COPD-HF burden warrants clinical awareness; extends GBD modeling but leaves open causal drivers and prevention targets.
Background: Chronic obstructive pulmonary disease (COPD) is strongly linked to heart failure (HF), but comprehensive global evaluations of COPD-associated HF remain limited. Methods: Using Global Burden of Disease Study 2021 data, we assessed prevalence and years lived with disability (YLDs) of COPD-associated HF. We applied decomposition analysis, Joinpoint regression, and Bayesian age-period-cohort modeling to evaluate trends by sex, age, sociodemographic index (SDI), and region, and to project burden to 2050. Results: In 2021, global COPD-associated HF cases exceeded 3.61 million, a 1.4-fold increase since 1990. Age-standardized prevalence rates (ASPR) and YLD rates (ASYR) increased overall. Absolute cases and YLDs rose in both sexes, but age-standardized rates declined in males and rose in females. Burden peaked at ages 70– 74 and grew fastest among those aged ≥ 95. The Middle SDI region had the highest counts; East Asia had the highest regional burden, and China the highest national absolute burden. Only High-SDI regions showed rising ASPR and ASYR; most other regions declined, notably Eastern Europe. Projections indicate global increases in ASPR and ASYR from 2022 to 2050, with slightly higher rises in females than males. Conclusion: The global burden of COPD-associated HF continues to rise with substantial heterogeneity and is projected to increase further. Coordinated international efforts and targeted prevention and management are urgently needed.
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Liu et al. (2026) conducted an observational in Chronic Obstructive Pulmonary Disease-Associated Heart Failure (n=3,613,136). COPD-associated Heart Failure vs. 1990 baseline was evaluated on Age-standardized prevalence rate (ASPR) trend (Average Annual Percentage Change) (AAPC 0.07, 95% CI 0.03-0.12). Global cases of COPD-associated heart failure exceeded 3.61 million in 2021, representing a 1.4-fold increase since 1990, with an overall increasing trend in the age-standardized prevalence rate.
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