Trends and cross-country disparity in the burden of pulmonary arterial hypertension: results from Global Burden of Disease Study 2021

Background Pulmonary hypertension (PH) is a cardiopulmonary disease with complicated etiologies and classifications, gradually attracting extensive attention due to its ever-growing disease burden. Here, we aim to elucidate the PH burden and trends at global, regional and country levels over the past thirty-two years. Methods Data about PH prevalence, death and disability-adjusted life-years (DALYs) were obtained from Global Burden of Disease Study 2021. Moreover, the relationship between PH burden and social development index was explored. Eventually, the relevance of PH to four cardiopulmonary comorbidities were verified. Results From the global perspective, PH prevalence was annually rising from 1990 to 2021, primarily affecting females and young adults (age from 15 to 49). While PH death also elevated during the past 32 years and was the elder predomination. DALYs of PH presented a slightly overall decrease but surged in underdeveloped areas. Nevertheless, age-standardized death rate and DALYs exhibited significantly declines, especially in relatively developed regions with advanced healthcare resources. At meanwhile, correlation analysis demonstrated a certain negative association of SDI with age-standardized death rate or age-standardized DALYs either across 21 regions or 204 countries. Eventually, the prevalence of PH showed strongly positive associations with that of four cardiopulmonary disorders including chronic obstructive pulmonary disease, interstitial lung disease, ischemic heart disease and hypertensive heart disease. Conclusion The current report suggested an increasingly serious burden of PH, particularly in less developed regions. Comprehensive understanding of PH epidemiology and high-risk comorbidities can benefit those dedicated to PH prevention and control.