Global, Regional, and National Burden of Pulmonary Arterial Hypertension Among Women of Childbearing Age, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.

Abstract

Pulmonary arterial hypertension (PAH) is a common condition among women of childbearing age (WCBA) and is associated with adverse outcomes during pregnancy. However, there is currently a lack of studies that provide a detailed epidemiological characterization of this condition. This study aimed to delineate the global burden of pulmonary arterial hypertension (PAH) among women of childbearing age (WCBA) from 1990 to 2021. We utilized the Global Burden of Disease Study 2021 to estimate the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for PAH among WCBA across 204 countries and territories from 1990 to 2021. Sociodemographic index (SDI) was used to assess the impact of socioeconomic development on PAH burden. In 2021, global estimates revealed 46,630 prevalent cases of PAH, resulting in 8532 new cases, 1777 deaths and 103,151 DALYs. Globally, the age-standardized prevalence, incidence, mortality, and DALY rates for PAH in 2021 stood at 2.35, 0.43, 0.09, and 5.26 per 100,000 population, respectively. In 2021, Switzerland exhibited the highest age-standardized prevalence rate (7.47/100,000). The highest age-standardized incidence rate was observed in Zambia (0.96/100,000). Mauritius reported the highest age-standardized mortality (0.72/100,000) and DALY rates (40.42/100,000), contrasting sharply with Moldova's lowest rates (0.00/100,000 and 0.51/100,000, respectively). At the regional level, the relationship between the SDI and age-standardized prevalence rates for PAH exhibited an approximate V-shaped pattern. The systematic analysis of PAH burden among WCBA underscores the disease's significant global impact and the necessity for continued research and tailored public health strategies, calling for enhanced awareness, improved diagnostics, and more effective treatment modalities, particularly in resource-constrained settings.