Burden of Hypertensive Heart Disease and Its Risk Factors in East Asia, 1990-2021: Findings From the Global Burden of Disease Study 2021.

Introduction: Long-term hypertensive heart disease (HHD) trends in East Asia offer insights for heart disease prevention. We analyzed HHD burden trends in East Asia (1990-2021).

Methods: We analyzed trends in age-standardized prevalence (ASPR), death, and disability-adjusted life-years (DALYs) rates of HHD in East Asia from 1990 to 2021 using data from the Global Burden of Disease Study 2021. Annual average percent changes (AAPC) were calculated via Joinpoint regression. Relative risks were estimated via population attributable fraction (PAF).

Results: In 2021, East Asia reported 4,354,899 prevalent cases of HHD, 361,483 deaths and 6,079,780 DALYs. East Asia has seen a decrease in the overall prevalence of hypertensive heart disease (HHD) from 1990 to 2021, yet the ASPR for HHD has increased in the last decade, from 2012 to 2021. During this period, developed areas such as Japan have observed a growing trend of HHD among younger demographics. In contrast, developing regions like North Korea continue to face challenges in managing the condition effectively. The burden of HHD is particularly pronounced among females over 75 years of age, while males exhibit higher risk due to poor lifestyle factors. From 1990 to 2021, the PAF due to high body mass index (BMI) consistently increased across East Asia, with the following AAPC and 95% confidence interval (95% CI): China (1.55, 95%CI: 1.54, 1.56), Japan (0.79, 95%CI: 0.78-0.81), South Korea (0.86, 95%CI: 0.85, 0.86), China-Taiwan (1.3, 95%CI: 1.28, 1.33), North Korea (1.55, 95%CI:1.54, 1.55), and Mongolia (0.24, 95%CI: 0.23, 0.25).

Conclusions: East Asia faces a significant HHD prevalence, with elderly females needing particular focus. High BMI is a notable risk factor. Given the differing HHD impacts across regions, targeted strategies that consider regional and national differences are essential for reducing the burden.