Key result
Global hypertensive heart disease prevalence rose ~18% from 1990 to 2021 despite declining mortality rates.
Why the study?
Hypertensive heart disease is a major cardiovascular consequence of prolonged hypertension, motivating an assessment of its global, regional, and national burden trends, socioeconomic inequalities, attributable risks, and projected trajectories.
Observational
Yes
Answers are grounded in this paper and cite their sources.
Despite declining age-standardized mortality and disability rates, the global prevalence and absolute burden of hypertensive heart disease continue to rise—driven notably by population aging, socioeconomic disparities, and increasing attribution to high body-mass index—underscoring the need for targeted blood pressure and weight management.
Hypertensive heart disease (HHD) is a major cardiovascular consequence of prolonged hypertension. This ecological study assessed global, regional, and national trends in HHD burden and its projected trajectories. The Global Burden of Disease Study 2021 provided estimates of Global Burden of Disease-defined HHD prevalence, deaths, disability-adjusted life-years (DALYs), and attributable risks for 204 countries and territories. Age-standardized prevalence rates (ASPRs), death rates (ASDRs), and DALY rates (ASDALYRs) were examined by sex, age, location, and Socio-demographic Index. Temporal trends, socioeconomic gradients, and frontier gaps were assessed. Autoregressive integrated moving average models generated exploratory projections from 2022 to 2031, with temporal holdout validation and sensitivity analysis. In 2021, HHD accounted for 12.51 million prevalent cases, 1.33 million deaths, and 25.46 million DALYs globally. From 1990 to 2021, ASPR increased from 125.44 to 148.32 per 100,000 population, whereas ASDR decreased from 20.92 to 16.32 and ASDALYR from 406.51 to 301.58 per 100,000 population. The burden was concentrated among older adults, shifted toward women at advanced ages, and remained higher in low- and middle-Socio-demographic Index settings. A high body-mass index was the leading selected risk factor other than high systolic blood pressure, with its DALY-attributable fraction increasing from 35.6 to 48.9%. By 2031, ASPR was projected to increase to 152.04 per 100,000 population, whereas ASDR and ASDALYR were projected to decline to 12.27 and 234.92 per 100,000 population, respectively. Validation and sensitivity analyses generally supported the qualitative consistency of these trajectories, although their magnitude varied for some series. HHD remains a growing chronic cardiovascular burden despite declining age-standardized fatal and disabling outcomes. Early hypertension detection, sustained blood pressure control, weight management, and targeted prevention in disadvantaged regions and older women are needed. The projections should be interpreted as exploratory.
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Yan et al. (2026) conducted an observational in Hypertensive heart disease (HHD). Socio-demographic Index (SDI) gradients and modifiable risk factors (high systolic blood pressure, high body-mass index, dietary sodium, low fruit intake, lead exposure, low temperature, high alcohol use) vs. Theoretical minimum risk exposure level (TMREL) and 1990 baseline rates was evaluated on Global age-standardized prevalence rate (ASPR), death rate (ASDR), and disability-adjusted life-year rate (ASDALYR) of hypertensive heart disease from 1990 to 2021 (95% CI 0.52-0.59). Global age-standardized HHD prevalence rose 18.24% (125.44 to 148.32 per 100,000) from 1990 to 2021, while death (20.92 to 16.32) and DALY rates (406.51 to 301.58) declined.
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