Global, Regional, and National Burden of Heart Failure Attributable to Chronic Obstructive Pulmonary Disease From 1990 to 2021, With Projections to 2050

Objectives: Heart failure (HF), a common comorbidity of chronic obstructive pulmonary disease (COPD), is associated with an increased risk of death among patients with COPD. However, no systematic assessment has quantified the population-level burden of comorbid COPD and HF, hereafter referred to as COPD-HF comorbidity, worldwide. This study assessed the global, regional, and national burden of COPD-HF comorbidity from 1990 to 2021 and projected this burden to 2050. Methods: Data on the non-fatal burden of COPD-HF comorbidity, including prevalence and years lived with disability (YLDs), were obtained from the Global Burden of Disease Study 2021. Temporal trends in age-standardized rates (ASRs) for COPD-HF comorbidity from 1990 to 2021 were examined using joinpoint models. Bayesian age-period-cohort models were used to project ASRs to 2050. Results: From 1990 to 2021, the absolute numbers of prevalent cases and YLDs for COPD-HF comorbidity increased globally, and the ASRs for prevalence and YLDs also increased. These upward trends were projected to continue to 2050. The burden of COPD-HF comorbidity was consistently higher in men than in women and higher in older adults than in younger individuals. By severity level, the burden of COPD-HF comorbidity was mainly attributable to the treated and severe subtypes of HF. The burden varied substantially across regions, with low-development regions having the highest age-standardized burden. Conclusions: The global non-fatal burden of COPD-HF comorbidity was substantial from 1990 to 2021 and may continue to increase to 2050. Public health interventions targeting COPD-HF comorbidity may help reduce this burden.