Global PAH deaths rose by 48.5% from 1990-2021, with a 76.6% increase in high SDI countries, despite decreases in age-standardized DALYs and death rates.
The global burden of PAH has shifted towards older populations and high SDI countries, with a projected continued increase in deaths and prevalence through 2050.
Abstract Background The lack of a comprehensive understanding of the burden of pulmonary arterial hypertension (PAH) significantly impedes its efficient clinical management. We aimed to determine PAH epidemiology globally, regionally, and nationally, including shifts in age and sex demographics and pediatric cases over the past three decades. Methods Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (2021) were analysed. Population shifts and temporal trends in PAH disability-adjusted life years (DALYs), deaths, and prevalence from 1990 to 2021 were examined. An age-period-cohort (APC) model was used to assess temporal trends in PAH burden, distinguishing the effects of age, period, and birth cohort. Regression models were utilized for global PAH burden projections through 2025. Results The global DALY counts decreased by 6.6%, while high SDI countries saw a 13.9% increase. Middle SDI regions recorded the largest DALYs cases both in 1990 and 2021. PAH-related deaths rose globally by 48.5%, with high SDI countries experiencing a 76.6% increase. In 2021, China, India, and the United States remained the top three countries in terms of DALY numbers. Age-standardized rates (ASRs) of DALYs and deaths decreased across all five SDI regions, with high-middle SDI countries showing the largest reductions. Younger age groups, especially males, had a higher proportion of global DALYs in earlier years, but the burden shifted towards older populations over time, with this trend more pronounced in high-SDI countries. In contrast, younger populations still bore a larger burden in low and lower-middle SDI countries. The APC model revealed that global DALYs rate for PAH decreased in younger age groups, with a notable increase in older populations. Projections for 2050 indicate continued increases in PAH-related deaths and prevalence, particularly among females. Conclusions The burden of PAH exhibited notable regional and national disparities. Greater efforts are needed to tackle this global challenge, with a focus on implementing targeted policies, improving healthcare accessibility, and enhancing early detection strategies, particularly in underserved areas.Burden of PAH APC results of representative countries
Yang et al. (2025) studied this question. Global PAH deaths rose by 48.5% from 1990-2021, with a 76.6% increase in high SDI countries, despite decreases in age-standardized DALYs and death rates.