Epidemiological Burden and Projections of Pulmonary Arterial Hypertension in China: An Analysis from the Global Burden of Disease Study 2021

Objective: Pulmonary arterial hypertension (PAH) is a severe condition with high morbidity and mortality, yet its epidemiology in China remains poorly understood. This study aims to assess the burden of PAH in China from 1990 to 2021 and project trends to 2050, providing insights for effective management and prevention strategies. Method: Data from the Global Burden of Disease (GBD) Study 2021 were analyzed, focusing exclusively on PAH. Key metrics included incidence, prevalence, mortality, and disability-adjusted life years (DALYs), along with their corresponding age-standardized rates (ASRs). Average annual percent changes (AAPCs) were calculated using joinpoint regression analysis, and a Bayesian age-period-cohort model was employed to project trends through 2050. Results: In 2021, there were 41,135 estimated prevalent cases of PAH (95% UI: 32,838.91 to 51,357.25) in China, with an age-standardized prevalence rate (ASPR) of 2.24 per 100,000. Females accounted for approximately 58% of cases. PAH caused 7,318 deaths (95% UI: 4,835.72 to 9,075.75; 3,683 males, 3,635 females), with an age-standardized death rate (ASDR) of 0.42 per 100,000. From 1990 to 2021, the ASPR increased slightly from 2.07 (95% UI: 1.68 to 2.54) to 2.24 (95% UI: 1.81 to 2.75), while the ASDR decreased from 0.61 (95% UI: 0.46 to 0.83) to 0.42 (95% UI: 0.28 to 0.51). Projections suggest declining trends in both ASPR and ASDR, although the overall prevalence of PAH is expected to rise over the next 30 years. Conclusion: PAH imposes a significant disease burden in China, particularly among women and older adults. These findings highlight the urgent need to enhance diagnostic capabilities and develop improved treatment strategies to address this challenging condition in the Chinese population.