Trends in the global, regional, and national burden of cardiovascular diseases attributed to high systolic blood pressure from 1990 to 2021 and projections to 2045: a systematic analysis based on GBD 2021 data.

Background: Cardiovascular disease (CVD) remains the leading cause of death and disability worldwide, and high systolic blood pressure (HSBP) is considered among its most critical modifiable risk factors. This study analyzed the temporal trends of the global burden of CVD attributed to HSBP from 1990 to 2021, examined its relationships with age, period, and birth cohort, and projected future trends to 2045.

Methods: The study employed a joinpoint regression model to evaluate the temporal trends of CVD burden attributed to HSBP from 1990 to 2021 and used an Age-Period-Cohort (APC) model to analyze the effects of age, period, and cohort. Additionally, a Bayesian Age-Period-Cohort (BAPC) model was applied to project the disease burden trends up to 2045.

Results: From 1990 to 2021, the absolute number of deaths and DALYs (disability-adjusted life years) of CVD attributed to HSBP increased significantly. However, the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a consistent declining trend. The study highlights significant regional differences, with the disease burden increasing most markedly in regions with a middle Socio-Demographic Index (SDI) and decreasing most significantly in high SDI regions. Additionally, the study revealed gender differences, with the decline in ASMR and ASDR was more pronounced in females, while males exhibited a higher overall disease burden than females. Projections from the BAPC model indicate that from 2022 to 2045, the absolute number of deaths and DALYs will continue to rise, while ASMR and ASDR will decline further.

Conclusions: This study conducted a comprehensive analysis of CVD attributed to HSBP globally, highlighting significant sex, age, and regional differences in disease burden as well as their temporal trends. The findings underscore the importance of targeted prevention strategies, particularly for high-risk populations. This study provides valuable insights for policymakers to formulate effective interventions to reduce the global disease burden.