Global, Regional, and National Burden of Hypertensive Heart Disease Among Older Adults in 204 Countries and Territories Between 1990 and 2019: a Trend Analysis

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2023 Sep 12

PMID 37698022

Authors

Ruixue Yang

Xun Zhang

Jingjing Bai

Lu Wang

Wenjie Wang

Jun Cai

Affiliations

Soon will be listed here.

Abstract

Background: Hypertensive heart disease (HHD) poses a public health challenge, but data on its burden and trends among older adults are scarce. This study aimed to identify trends in the burden of HHD among older adults between 1990 and 2019 at the global, regional, and national levels.

Methods: Using the Global Burden of Diseases study 2019 data, we assessed HHD prevalence, death, and disability-adjusted life-year (DALY) rates for individuals aged 60-89 years at the global, regional, and national levels and estimated their average annual percentage changes (AAPCs) between 1990 and 2019 using joinpoint regression analysis.

Results: In 2019, there were 14.35 million HHD prevalent cases, 0.85 million deaths, and 14.56 million DALYs in older adults. Between 1990 and 2019, the prevalence of HHD increased globally {AAPC, 0.38 (95% confidence interval [CI], 0.36, 0.41)} with decreases observed in mortality (AAPC, -0.83 [95% CI, -0.99, -0.66]) and the DALY rate (AAPC, -1.03 [95% CI, -1.19, -0.87]). This overall global trend pattern was essentially maintained for sex, age group, and sociodemographic index (SDI) quintile except for non-significant changes in the prevalence of HHD in those aged 70-74 years and in the middle SDI quintile. Notably, males had a higher HHD prevalence rate. However, HHD-related mortality and the DALY rate were higher in females. The middle SDI quintile experienced the largest decreases in mortality and the DALY rate, with a non-significant decline in prevalence between 1990 and 2019. There were significant discrepancies in the HHD burden and its trends across regions and countries.

Conclusions: In the past three decades, there has been an overall increasing trend in the prevalence of HHD among older adults worldwide despite decreasing trends in mortality and the DALY rate. Better management of hypertension, and prevention and control of HHD are needed in older adults.

Citing Articles

The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies.

Peng X, Wan L, Yu B, Zhang J BMC Cardiovasc Disord. 2025; 25(1):145.

PMID: 40033219 PMC: 11874117. DOI: 10.1186/s12872-025-04538-6.

Global burden of ischemic heart disease in older adult populations linked to non-optimal temperatures: past (1990-2021) and future (2022-2050) analysis.

Liu L, He Y, Huang G, Zeng Y, Lu J, He R Front Public Health. 2025; 13:1548215.

PMID: 40013054 PMC: 11861215. DOI: 10.3389/fpubh.2025.1548215.

Epidemiological characteristics of infertility, 1990-2021, and 15-year forecasts: an analysis based on the global burden of disease study 2021.

Feng J, Wu Q, Liang Y, Liang Y, Bin Q Reprod Health. 2025; 22(1):26.

PMID: 39972325 PMC: 11841318. DOI: 10.1186/s12978-025-01966-7.

Human papillomavirus and male infertility correlation analysis following World Health Organization 2021 guidelines.

Notari T, Butta M, Serra N, Sucato A, Rizzo G, Capra G Sci Rep. 2024; 14(1):27422.

PMID: 39521918 PMC: 11550413. DOI: 10.1038/s41598-024-79047-1.

Hypotensive and Cardioprotective Potential of Yellow Bedstraw Extract-Based Oral Liquid in Spontaneously Hypertensive Rats.

Bradic J, Petrovic A, Kocovic A, Mitrovic S, Jakovljevic V, Lazarevic N Int J Mol Sci. 2024; 25(15).

PMID: 39125920 PMC: 11313326. DOI: 10.3390/ijms25158346.

References

Diez J, Rosano G, Butler J . Time to reconsider the perception and management of hypertensive heart disease. Eur J Heart Fail. 2023; 25(4):450-453. DOI: 10.1002/ejhf.2811. View

Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P . Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2019; 395(10226):795-808. PMC: 8006904. DOI: 10.1016/S0140-6736(19)32008-2. View

Anand S, Hawkes C, de Souza R, Mente A, Dehghan M, Nugent R . Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. J Am Coll Cardiol. 2015; 66(14):1590-1614. PMC: 4597475. DOI: 10.1016/j.jacc.2015.07.050. View

Geldsetzer P, Manne-Goehler J, Marcus M, Ebert C, Zhumadilov Z, Wesseh C . The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults. Lancet. 2019; 394(10199):652-662. DOI: 10.1016/S0140-6736(19)30955-9. View

Cuspidi C, Sala C, Negri F, Mancia G, Morganti A . Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens. 2011; 26(6):343-9. DOI: 10.1038/jhh.2011.104. View

Whelton P, Carey R, Aronow W, Casey Jr D, Collins K, Himmelfarb C . 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on.... Hypertension. 2017; 71(6):e13-e115. DOI: 10.1161/HYP.0000000000000065. View

Walli-Attaei M, Joseph P, Rosengren A, Chow C, Rangarajan S, Lear S . Variations between women and men in risk factors, treatments, cardiovascular disease incidence, and death in 27 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2020; 396(10244):97-109. DOI: 10.1016/S0140-6736(20)30543-2. View

Diez J, Butler J . Growing Heart Failure Burden of Hypertensive Heart Disease: A Call to Action. Hypertension. 2022; 80(1):13-21. DOI: 10.1161/HYPERTENSIONAHA.122.19373. View

. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159):1859-1922. PMC: 6252083. DOI: 10.1016/S0140-6736(18)32335-3. View

10.

Clegg L, Hankey B, Tiwari R, Feuer E, Edwards B . Estimating average annual per cent change in trend analysis. Stat Med. 2009; 28(29):3670-82. PMC: 2843083. DOI: 10.1002/sim.3733. View

11.

Wright Jr J, Williamson J, Whelton P, Snyder J, Sink K, Rocco M . A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015; 373(22):2103-16. PMC: 4689591. DOI: 10.1056/NEJMoa1511939. View

12.

. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021; 398(10304):957-980. PMC: 8446938. DOI: 10.1016/S0140-6736(21)01330-1. View

13.

Rizzoni D, De Ciuceis C, Szczepaniak P, Paradis P, Schiffrin E, Guzik T . Immune System and Microvascular Remodeling in Humans. Hypertension. 2022; 79(4):691-705. DOI: 10.1161/HYPERTENSIONAHA.121.17955. View

14.

Timmis A, Townsend N, Gale C, Torbica A, Lettino M, Petersen S . European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J. 2019; 41(1):12-85. DOI: 10.1093/eurheartj/ehz859. View

15.

Micha R, Penalvo J, Cudhea F, Imamura F, Rehm C, Mozaffarian D . Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA. 2017; 317(9):912-924. PMC: 5852674. DOI: 10.1001/jama.2017.0947. View

16.

Joshi R, Jan S, Wu Y, MacMahon S . Global inequalities in access to cardiovascular health care: our greatest challenge. J Am Coll Cardiol. 2008; 52(23):1817-1825. DOI: 10.1016/j.jacc.2008.08.049. View

17.

Dai H, Bragazzi N, Younis A, Zhong W, Liu X, Wu J . Worldwide Trends in Prevalence, Mortality, and Disability-Adjusted Life Years for Hypertensive Heart Disease From 1990 to 2017. Hypertension. 2021; 77(4):1223-1233. DOI: 10.1161/HYPERTENSIONAHA.120.16483. View

18.

Tan X, Liu X, Shao H . Healthy China 2030: A Vision for Health Care. Value Health Reg Issues. 2017; 12:112-114. DOI: 10.1016/j.vhri.2017.04.001. View

19.

Ogata S, Nishimura K, Guzman-Castillo M, Sumita Y, Nakai M, Nakao Y . Explaining the decline in coronary heart disease mortality rates in Japan: Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012. Int J Cardiol. 2019; 291:183-188. DOI: 10.1016/j.ijcard.2019.02.022. View

20.

. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1223-1249. PMC: 7566194. DOI: 10.1016/S0140-6736(20)30752-2. View