Abstract
BACKGROUND: Hypertensive heart disease remains a growing global health challenge, especially in regions with limited socioeconomic development. Understanding how its prevalence, mortality, and disability burden have changed over time is crucial for guiding prevention and control strategies. This study analyzed global trends from 1990 to 2021, examined differences by sex and development level, and projected future patterns to 2046. METHODS: Utilizing data from the Global Burden of Disease (GBD) study, we examined patterns in the occurrence, death rates, and DALYs of hypertensive heart disease from 1990 to 2021; analyzed the time-based patterns of the average annual percentage change (AAPC) through joinpoint regression models; and evaluated the effects of aging, demographic expansion, and epidemiological shifts in hypertensive heart disease burden by integrating frontier and decomposition studies. An assessment of hypertensive heart disease burden and Bayesian age-period-cohort (APC) modeling techniques were employed to forecast future patterns. RESULTS: From 1990 to 2021, the worldwide incidence of hypertensive heart disease increased from 4,626,598 to 12,505,436 cases, accompanied by a 0.53% AAPC; the number of hypertensive heart disease-related deaths increased from 713,935 to 1,332,099 cases, with a -0.79% AAPC; and the number of DALYs increased from 15,473,830 to 25,462,185 years, with a -0.95% AAPC. The incidence in females was marginally greater than that in males, yet there were comparable decreases in deaths and DALYs for both sexes. There was a notable increase in prevalence in regions with high SDIs, whereas areas with low SDIs experienced greater disease burdens. The increasing worldwide burden of hypertensive heart disease is attributed primarily to aging and population growth. According to the APC model, the worldwide incidence of hypertensive heart disease is expected to increase from 2022 to 2046, with further decreases in deaths and DALYs. CONCLUSIONS: This study systematically reveals the increasing trend in the incidence of hypertensive heart disease globally between 1990 and 2021 and confirms the significant impact of sex and socioeconomic development level on its burden. Forecasts to 2046 indicate that the prevalence will continue to rise, although mortality may decline, achieving the research objective of exploring the global and regional epidemiological characteristics and future trends of hypertensive heart disease.