Abstract
BACKGROUND AND AIMS: Heart failure (HF) represents a major global health challenge. This study utilized the Global Burden of Disease (GBD) dataset to analyse HF epidemiology from 1990 to 2021 and project disease burden to 2035. METHODS: We analysed GBD 2021 data on HF attributable to cardiovascular diseases (CVDs) for 1990-2021. Age-period-cohort modelling assessed the effects of age, time period, and birth cohort on HF. Joinpoint regression analysis characterized temporal trends and annual percentage changes (APC) in the age-standardized prevalence rate (ASPR) and years lived with disability (YLDs) for HF due to ischaemic heart disease (IHD) and hypertensive heart disease (HHD). The Bayesian age-period-cohort (BAPC) model projected HF patient numbers and ASPR for 2022-2035. RESULTS: Globally, an increased risk of developing HF started at age 60 and after the period 2005-2009. Birth cohorts showed protective factors after 1955-1959. The Joinpoint model suggested that ASPR of HF resulting from IHD gradually decreased since 2019 (APC = -0.74, 95% UI: -0.94 to -0.55, P < .001). HHD showed a continuous upward trend in male patients, while decreasing in females after 2019 (APC = -0.47, 95% UI: -0.74 to -0.20, P < .01). Between 1990 and 2021, CVDs-attributable HF cases and YLDs rose from 20.1 million (95% UI: 17.3-23.4) and 1.92 million (95% UI: 1.28-2.66) to 45.6 million (95% UI: 39.7-52.7) and 4.32 million (95% UI: 2.96-5.94), respectively, representing increases of 127% and 126%. ASPR and age-standardized YLD rates increased by 3.74% and 3.36%. Projections indicate the global HF population will reach 27.0 million (95% UI: 21.6-32.5) males and 21.5 million (95% UI: 16.8-26.3) females by 2035, with stable ASPR. CONCLUSIONS: The rising absolute number of HF patients indicates a substantial CVD-attributable burden by 2035, necessitating enhanced focus on individuals over 60, particularly those with IHD and HHD.