ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Hypertension
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1617610
Mortality and trends of pulmonary arterial hypertension, 1990-2021: a population-based study
Provisionally accepted
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Abstract Background: Pulmonary arterial hypertension (PAH) is a progressive disease associated with high fatality rate. Comprehensive evidence concerning the epidemiology of PAH mortality is lacking. The present study aimed to assess the mortality and trends of PAH at global, regional, and national levels from 1990 to 2021. Methods: The estimates and their 95% uncertainty interval for case number of PAH were collected from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. Age standardization by direct method was used to estimate the age-standardized mortality rate (ASMR) for PAH. We investigated the temporal trends of estimated ASMR from 1990 to 2021 and further predicted its changes in the next 15 years, decomposed the trends based on demographic factors and epidemiological changes, and quantified the cross-country health inequalities. Results: The global ASMR of PAH decreased from 0.35 (per 100,000 population) in 1990 to 0.27 (per 100,000 population) in 2021, with an annual percentage change of - 0.82, while number of deaths increased from 14,842 in 1990 to 22,021 in 2021, an increase of 48.37%. Population growth and aging were the major drivers contributing to the number of deaths, accounting for 93.88% and 32.26%. Of note, there were significant health inequalities across 204 countries and territories, with the slope index of inequality rising over time. Projection of the global burden of PAH from 2022 to 2036 demonstrated a progressive increase in case number, but the ASMR remained largely unchanged. Conclusion: PAH remains a major public health concern in some regions, particularly in high sociodemographic index region. Adequate diagnosis and targeted treatment of PAH are urgently needed to achieve a reduction in mortality.
Keywords: Hypertension, pulmonary arterial hypertension, Global burden of disease, Trends, Mortality
Received: 24 Apr 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Jiang, Deng, He, Ai, Li, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Peijun Li, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Xiaodan Liu, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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