What is the clinical evidence from this study?

Study design: Observational. Population: Heart failure. Intervention: Time (1990 to 2021). Primary outcome: Estimated annual percentage change (EAPC) in global heart failure prevalence (EAPC 2.50%, 95% CI 1.97-3.03, p=<0.05).

What does this research mean for the field?

Global heart failure prevalence increased from 25.43 million in 1990 to 55.50 million in 2021, with China experiencing an even faster growth rate than the global average. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 15, 2025Open Access

Global and Chinese perspectives on the growing burden of heart failure: trends, gender, and age-related differences (1990–2021) based on GBD 2021 data

Q: What are the key findings of this study?

Global heart failure prevalence increased from 25.43 million in 1990 to 55.50 million in 2021 (EAPC 2.50%), with China experiencing an even faster growth rate (EAPC 3.18%).

Q: What does this research mean for the field?

Global heart failure prevalence increased from 25.43 million in 1990 to 55.50 million in 2021, with China experiencing an even faster growth rate than the global average. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Global heart failure prevalence increased from 25.43 million in 1990 to 55.50 million in 2021 (EAPC 2.50%), with China experiencing an even faster growth rate (EAPC 3.18%).

Study Design

Type

Observational

Structured PICO

Population

Global population across 204 countries, specifically analyzing heart failure burden globally and in China from 1990 to 2021.

Outcome

Trends in prevalence and years lived with disability (YLDs) of heart failure

The global burden of heart failure has significantly increased from 1990 to 2021, with a particularly rapid rise in China and among older males.

Main Result

Effect estimate: EAPC 2.50% (95% CI 1.97-3.03)

p-value: p=<0.05

Limitations

Limitations of data sources, including underreporting and limited diagnostic capacity in low-income countries
Insufficient differentiation between specific types of heart failure (e.g., HFrEF and HFpEF)
Changes in diagnostic criteria over time may have influenced observed trends
Insufficient consideration of socioeconomic factors and access to healthcare services
No sensitivity analyses were conducted
Gaps in data sources for certain regions or time periods, with reliance on modeled estimates

Abstract

BACKGROUND: Heart failure (HF) is a growing global health issue, contributing to significant disease burden and increased mortality. The Global Burden of Disease (GBD) study offers comprehensive data on HF trends by age, sex, and region. OBJECTIVE: This study aimed to analyze trends in prevalence and years lived with disability (YLDs) of HF in China and globally from 1990 to 2021 based on GBD 2021 data. METHODS: A retrospective analysis using GBD 2021 data was conducted, covering HF burden in 204 countries from 1990 to 2021. Data were analyzed using Joinpoint regression and stratified by age and sex. RESULTS: Global HF prevalence increased from 25.43 million in 1990 to 55.50 million in 2021, with an estimated annual percentage change (EAPC) of 2.50%. YLDs rose from 2.42 million to 5.31 million. In China, the EAPC for HF prevalence was 3.18%, surpassing the global rate. Males exhibited higher HF burden than females, and the disease burden rose sharply in those aged 65 and older. CONCLUSION: Both global and Chinese HF burdens increased from 1990 to 2021, with China experiencing faster growth. Key public health recommendations include improving early screening, promoting lifestyle interventions, enhancing healthcare access, and integrating new therapies for heart failure.

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