{
  "abstract": "Hypertensive heart disease (HHD) is a major cardiovascular consequence of prolonged hypertension. This ecological study assessed global, regional, and national trends in HHD burden and its projected trajectories. The Global Burden of Disease Study 2021 provided estimates of Global Burden of Disease-defined HHD prevalence, deaths, disability-adjusted life-years (DALYs), and attributable risks for 204 countries and territories. Age-standardized prevalence rates (ASPRs), death rates (ASDRs), and DALY rates (ASDALYRs) were examined by sex, age, location, and Socio-demographic Index. Temporal trends, socioeconomic gradients, and frontier gaps were assessed. Autoregressive integrated moving average models generated exploratory projections from 2022 to 2031, with temporal holdout validation and sensitivity analysis. In 2021, HHD accounted for 12.51 million prevalent cases, 1.33 million deaths, and 25.46 million DALYs globally. From 1990 to 2021, ASPR increased from 125.44 to 148.32 per 100,000 population, whereas ASDR decreased from 20.92 to 16.32 and ASDALYR from 406.51 to 301.58 per 100,000 population. The burden was concentrated among older adults, shifted toward women at advanced ages, and remained higher in low- and middle-Socio-demographic Index settings. A high body-mass index was the leading selected risk factor other than high systolic blood pressure, with its DALY-attributable fraction increasing from 35.6 to 48.9%. By 2031, ASPR was projected to increase to 152.04 per 100,000 population, whereas ASDR and ASDALYR were projected to decline to 12.27 and 234.92 per 100,000 population, respectively. Validation and sensitivity analyses generally supported the qualitative consistency of these trajectories, although their magnitude varied for some series. HHD remains a growing chronic cardiovascular burden despite declining age-standardized fatal and disabling outcomes. Early hypertension detection, sustained blood pressure control, weight management, and targeted prevention in disadvantaged regions and older women are needed. The projections should be interpreted as exploratory.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Medicine, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China",
    "Department of Digital Science and Intelligent Software, South China University of Technology, Guangzhou, Guangdong, China",
    "Department of Cardiovascular Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Changshun Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Su Hu"
    },
    {
      "affs": [
        1
      ],
      "name": "Hangyu Cao"
    },
    {
      "affs": [
        0
      ],
      "name": "Min Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Rui Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Menghan Xu"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Genshan Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Guiqiu Cao",
      "orcid": "0009-0001-1290-0271"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ck2pkpx4p4p33.bib",
  "cited_by": 0,
  "doi": "10.1097/md.0000000000051248",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727210/?tool=EBI",
  "id": "ck2pkpx4p4p33",
  "issns": [
    "0304-5412",
    "1536-5964",
    "0025-7974"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727210",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "3400"
    ],
    [
      "heading",
      "Observational Study"
    ],
    [
      "heading",
      "Research Article"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727210/pdf/?tool=EBI",
  "pmcid": "PMC13727210",
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/ck2pkpx4p4p33.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13727210",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727210"
    },
    {
      "first_seen": "2026-11-05T12:23:20Z",
      "native_id": "PMC13727210",
      "source": "pmc",
      "url": "https://doi.org/10.1097/md.0000000000051248"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Global inequalities, attributable risks, and future trends in hypertensive heart disease burden : An ecological study based on the Global Burden of Disease Study 2021, 1990–2021",
  "title_text": "Global inequalities, attributable risks, and future trends in hypertensive heart disease burden : An ecological study based on the Global Burden of Disease Study 2021, 1990–2021",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:56Z",
  "url": "https://research.draconitic.com/paper/ck2pkpx4p4p33",
  "venue": "Medicine",
  "versions": []
}