Changing patterns of heart failure in China from 1990 to 2021: a secondary analysis of the global burden of disease study 2021

To assess the changing patterns of heart failure (HF) in China from 1990 to 2021, providing evidence for informed healthcare strategies.

Data on prevalence, years lived with disability (YLDs), and their corresponding 95% uncertainty intervals (UI) were obtained from the Global Burden of Disease (GBD) Study 2021. The joinpoint regression model, the age-period-cohort model, and the autoregressive integrated moving average (ARIMA) model were utilized for more in-depth analysis. In 2021, 13 099 727 (95% UI, 11 320 895 to 15 376 467) individuals lived with HF and this illness accounted for 1 290 810 (95% UI, 865 894 to 1 775 731) YLDs in China. The burden of HF is more pronounced in males and the elderly, with ischaemic heart disease having become the leading cause since 2002. The age-standardized rates of prevalence and YLDs increased at average annual percentage changes of 0.23% (95% CI, 0.20 to 0.26) and 0.25% (95% CI, 0.23 to 0.27), respectively. The curve of local drift showed a downward trend with age. Both the period and cohort rate ratios have increased significantly over the last 30 years. By 2031, the age-standardized rates of prevalence will decrease to 678.69 (95% CI, 640.75 to 716.63), while the age-standardized rates of YLDs will increase to 69.19 (95% CI, 66.95 to 71.43).

The burden and risk of HF in China remains a major concern. The implementation of comprehensive strategies should be taken into consideration, including strengthening the primary healthcare system, enhancing public health education, and promoting cardiac rehabilitation.