{"title":"1990年至2021年全球、地区和国家肺动脉高压负担和2040年预测：发病率、死亡率和残疾调整生命年的系统分析","authors":"Lin-Ling Yu, Ding-Sheng Jiang, Xiong Wang, Ze-Min Fang, Wei-Hong Chen, Jin-Zhu Zhao, Xin Yi, Wei Liu","doi":"10.1007/s11596-025-00108-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary arterial hypertension (PAH) poses a growing global health challenge, yet comprehensive epidemiological data remain limited. This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040, addressing critical gaps in incidence, mortality, and disability-adjusted life years (DALYs) across diverse socio-demographic contexts.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed PAH burden across 204 countries and territories, stratified by age, sex, region, and socio-demographic index (SDI). Age-standardized rates (per 100,000 populations) for incidence (ASIR), mortality (ASMR), and DALYs (ASDR) were calculated. Future trends were projected via a Bayesian age-period-cohort (BAPC) model.</p><p><strong>Results: </strong>In 2021, there were 43,251 (95% uncertainty interval [UI]: 34,705, 52,441) global incident PAH cases (age standardized incidence rate [ASIR]: 0.52). From 1990 to 2021, PAH incidence rose by 85.62%, with the steepest increase in high-middle SDI regions (average annual percentage change [AAPC]: + 0.19%). Despite a 48.36% rise in deaths, the age-standardized mortality rate (ASMR) declined annually by 0.84%, reflecting improved management. Central Europe had the highest ASMR (1.06 per 100,000), while low SDI regions showed reduced ASIR (-0.31% AAPC), likely due to underdiagnosis. PAH caused 642,104 DALYs globally in 2021, with infants (< 1 year) bearing the highest DALY rate. Projections indicate 75,000 annual cases by 2040, emphasizing an escalating burden.</p><p><strong>Conclusion: </strong>PAH burden is increasing disproportionately in aging populations and high-middle SDI regions, while low SDI areas face underdiagnosis and healthcare disparities. Targeted interventions, equitable resource allocation, and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Global, Regional, and National Burden of Pulmonary Arterial Hypertension from 1990 to 2021 and Projections to 2040: A Systematic Analysis of Incidence, Mortality, and Disability-Adjusted Life Years.\",\"authors\":\"Lin-Ling Yu, Ding-Sheng Jiang, Xiong Wang, Ze-Min Fang, Wei-Hong Chen, Jin-Zhu Zhao, Xin Yi, Wei Liu\",\"doi\":\"10.1007/s11596-025-00108-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Pulmonary arterial hypertension (PAH) poses a growing global health challenge, yet comprehensive epidemiological data remain limited. This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040, addressing critical gaps in incidence, mortality, and disability-adjusted life years (DALYs) across diverse socio-demographic contexts.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed PAH burden across 204 countries and territories, stratified by age, sex, region, and socio-demographic index (SDI). Age-standardized rates (per 100,000 populations) for incidence (ASIR), mortality (ASMR), and DALYs (ASDR) were calculated. Future trends were projected via a Bayesian age-period-cohort (BAPC) model.</p><p><strong>Results: </strong>In 2021, there were 43,251 (95% uncertainty interval [UI]: 34,705, 52,441) global incident PAH cases (age standardized incidence rate [ASIR]: 0.52). From 1990 to 2021, PAH incidence rose by 85.62%, with the steepest increase in high-middle SDI regions (average annual percentage change [AAPC]: + 0.19%). Despite a 48.36% rise in deaths, the age-standardized mortality rate (ASMR) declined annually by 0.84%, reflecting improved management. Central Europe had the highest ASMR (1.06 per 100,000), while low SDI regions showed reduced ASIR (-0.31% AAPC), likely due to underdiagnosis. PAH caused 642,104 DALYs globally in 2021, with infants (< 1 year) bearing the highest DALY rate. Projections indicate 75,000 annual cases by 2040, emphasizing an escalating burden.</p><p><strong>Conclusion: </strong>PAH burden is increasing disproportionately in aging populations and high-middle SDI regions, while low SDI areas face underdiagnosis and healthcare disparities. Targeted interventions, equitable resource allocation, and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.</p>\",\"PeriodicalId\":10820,\"journal\":{\"name\":\"Current Medical Science\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Medical Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11596-025-00108-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Medical Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11596-025-00108-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Global, Regional, and National Burden of Pulmonary Arterial Hypertension from 1990 to 2021 and Projections to 2040: A Systematic Analysis of Incidence, Mortality, and Disability-Adjusted Life Years.
Objective: Pulmonary arterial hypertension (PAH) poses a growing global health challenge, yet comprehensive epidemiological data remain limited. This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040, addressing critical gaps in incidence, mortality, and disability-adjusted life years (DALYs) across diverse socio-demographic contexts.
Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed PAH burden across 204 countries and territories, stratified by age, sex, region, and socio-demographic index (SDI). Age-standardized rates (per 100,000 populations) for incidence (ASIR), mortality (ASMR), and DALYs (ASDR) were calculated. Future trends were projected via a Bayesian age-period-cohort (BAPC) model.
Results: In 2021, there were 43,251 (95% uncertainty interval [UI]: 34,705, 52,441) global incident PAH cases (age standardized incidence rate [ASIR]: 0.52). From 1990 to 2021, PAH incidence rose by 85.62%, with the steepest increase in high-middle SDI regions (average annual percentage change [AAPC]: + 0.19%). Despite a 48.36% rise in deaths, the age-standardized mortality rate (ASMR) declined annually by 0.84%, reflecting improved management. Central Europe had the highest ASMR (1.06 per 100,000), while low SDI regions showed reduced ASIR (-0.31% AAPC), likely due to underdiagnosis. PAH caused 642,104 DALYs globally in 2021, with infants (< 1 year) bearing the highest DALY rate. Projections indicate 75,000 annual cases by 2040, emphasizing an escalating burden.
Conclusion: PAH burden is increasing disproportionately in aging populations and high-middle SDI regions, while low SDI areas face underdiagnosis and healthcare disparities. Targeted interventions, equitable resource allocation, and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.
期刊介绍：
Current Medical Science provides a forum for peer-reviewed papers in the medical sciences, to promote academic exchange between Chinese researchers and doctors and their foreign counterparts. The journal covers the subjects of biomedicine such as physiology, biochemistry, molecular biology, pharmacology, pathology and pathophysiology, etc., and clinical research, such as surgery, internal medicine, obstetrics and gynecology, pediatrics and otorhinolaryngology etc. The articles appearing in Current Medical Science are mainly in English, with a very small number of its papers in German, to pay tribute to its German founder. This journal is the only medical periodical in Western languages sponsored by an educational institution located in the central part of China.
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