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Background <p>The causes of pulmonary arterial hypertension (PAH) are complex, the treatment methods are limited, and the incidence rate varies greatly among regions.</p> Aims <p>This study aims to describe the time trends of age- and sex-specific disease burden of PAH in China from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare these trends with the disease burden in India.</p> Methods <p>Using publicly available data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analyzed the characteristics of the PAH burden in China and India, including changes in incidence, prevalence, mortality, and DALYs. The Joinpoint software was used to calculate the average annual percentage change (AAPC) and the corresponding uncertainty intervals (95% UI) to reflect the trends of PAH burden. A comprehensive comparative analysis and prediction were made for the differences in PAH burden between China and India across multiple dimensions, including age, gender, and period.</p> Results <p>From 1990 to 2021, the age-standardized incidence rate (ASIR) of PAH in China decreased from 0.51/100,000 to 0.50/100,000, while the ASIR in India decreased from 0.58/100,000 to 0.56/100,000. The age-standardized prevalence rate (ASPR) in China increased from 2.07/100,000 to 2.24/100,000, while India’s ASPR increased from 1.62/100,000 to 1.74/100,000. The age-standardized mortality rate (ASMR) in China decreased from 0.61/100,000 to 0.42/100,000, while India’s ASMR decreased from 0.29/100,000 to 0.24/100,000. The age-standardized DALY rate (ASDR) in China decreased from 16.18/100,000 to 8.95/100,000, while India’s ASDR decreased from 11.73/100,000 to 7.75/100,000. The AAPC for China’s PAH burden in ASIR, ASPR, ASMR, and ASDR was -0.07%, 0.25%, − 1.26%, and − 1.91%, respectively, while the AAPC for India’s PAH burden was − 0.09%, 0.22%, − 0.66%, and − 1.32%, respectively. In China, the incidence and prevalence of PAH were higher in the 45–74 age group, and the mortality rate was higher in the 70–89 age group; while in India, the incidence and prevalence were higher in the 30–74 age group, and the mortality rates were higher in the &lt; 5&#xa0;years and 65–84&#xa0;years age groups. Projections for 2022–2036 suggest a slight increase in the ASIR and ASDR of PAH in China, but overall changes are minimal.</p> Conclusion <p>Both China and India have large populations, and the disease burden of PAH remains severe. China should focus on strengthening screening interventions for PAH in the middle-aged and elderly populations, while India should particularly focus on strengthening screening and diagnosis for PAH in children under 5&#xa0;years old to reduce mortality.</p>

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The trend analysis and comparison of pulmonary arterial hypertension disease burden in China and India from 1990 to 2021: a study based on the Global Burden of Disease 2021 database

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  • 发表日期：

    2025年12月11日

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  • Xuchi Chen,
  • Dongdong Yan,
  • Chang Liu,
  • Jian Dai,
  • Zhijing Li,
  • Yu Lu

摘要

Background

The causes of pulmonary arterial hypertension (PAH) are complex, the treatment methods are limited, and the incidence rate varies greatly among regions.

Aims

This study aims to describe the time trends of age- and sex-specific disease burden of PAH in China from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare these trends with the disease burden in India.

Methods

Using publicly available data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analyzed the characteristics of the PAH burden in China and India, including changes in incidence, prevalence, mortality, and DALYs. The Joinpoint software was used to calculate the average annual percentage change (AAPC) and the corresponding uncertainty intervals (95% UI) to reflect the trends of PAH burden. A comprehensive comparative analysis and prediction were made for the differences in PAH burden between China and India across multiple dimensions, including age, gender, and period.

Results

From 1990 to 2021, the age-standardized incidence rate (ASIR) of PAH in China decreased from 0.51/100,000 to 0.50/100,000, while the ASIR in India decreased from 0.58/100,000 to 0.56/100,000. The age-standardized prevalence rate (ASPR) in China increased from 2.07/100,000 to 2.24/100,000, while India’s ASPR increased from 1.62/100,000 to 1.74/100,000. The age-standardized mortality rate (ASMR) in China decreased from 0.61/100,000 to 0.42/100,000, while India’s ASMR decreased from 0.29/100,000 to 0.24/100,000. The age-standardized DALY rate (ASDR) in China decreased from 16.18/100,000 to 8.95/100,000, while India’s ASDR decreased from 11.73/100,000 to 7.75/100,000. The AAPC for China’s PAH burden in ASIR, ASPR, ASMR, and ASDR was -0.07%, 0.25%, − 1.26%, and − 1.91%, respectively, while the AAPC for India’s PAH burden was − 0.09%, 0.22%, − 0.66%, and − 1.32%, respectively. In China, the incidence and prevalence of PAH were higher in the 45–74 age group, and the mortality rate was higher in the 70–89 age group; while in India, the incidence and prevalence were higher in the 30–74 age group, and the mortality rates were higher in the < 5 years and 65–84 years age groups. Projections for 2022–2036 suggest a slight increase in the ASIR and ASDR of PAH in China, but overall changes are minimal.

Conclusion

Both China and India have large populations, and the disease burden of PAH remains severe. China should focus on strengthening screening interventions for PAH in the middle-aged and elderly populations, while India should particularly focus on strengthening screening and diagnosis for PAH in children under 5 years old to reduce mortality.