ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fped.2025.1614880
This article is part of the Research TopicChildren in Global Health: Promoting Health Equity from the Perspective of Media, Culture and CommunicationView all 6 articles
Epidemiology and Trends of Pediatric Pulmonary Arterial Hypertension from 1990 to 2021: Insights from the Global Burden of Disease Study
Provisionally accepted
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Pulmonary arterial hypertension (PAH) is a rare but life-threatening condition in children, often associated with delayed diagnosis and high mortality. However, global estimates of its burden in pediatric populations remain limited, particularly in lowand middle-income settings.data from the Global Burden of Disease Study 2021, we assessed the incidence, mortality, and disability-adjusted life years (DALYs) due to pediatric (0-14 years) PAH across 204 countries and territories from 1990 to 2021. Mortality was estimated with the Cause of Death Ensemble model (CODEm), while temporal patterns were evaluated using estimated annual percentage change (EAPC) and segmented regression-derived average annual percent change (AAPC). Socioeconomic disparities were examined through the slope index of inequality (SII) and concentration index (CII) based on Socio-demographic Index (SDI) quintiles.Globally, the mortality rate due to PAH in children declined from 0.23 (95% UI: 0.14-0.32) per 100,000 in 1990 to 0.085 (95% UI:0.067-0.104) per 100,000 in 2021, and DALY rates dropped from 20.63 (95% UI: 12.02-28.69) per 100,000 to 7.51 (95% UI:5.95-9.20) per 100,000. In contrast, incidence rate remained relatively stable, increasing slightly from 0.178 (95% UI:0.129-0.234) per 100,000 to 0.184 (95% UI:0.133-0.244) per 100,000. The most substantial mortality and DALY declines were observed in high-SDI regions, while low-SDI countries, particularly in Sub-Saharan Africa and South Asia, showed slower progress. Segmented regression identified accelerated declines in mortality between 2017 and 2021 (AAPC: -7.39% for mortality). From 1990 to 2021, SII values declined, indicating a narrowing in absolute inequality; however, CII values became increasingly negative.Despite global reductions in mortality and DALY burden from pediatric PAH, progress has been uneven. Children in low-SDI countries continue to face disproportionate burden. Targeted interventions, improved diagnostics, and equityfocused health system strengthening are urgently needed to reduce pediatric cardiovascular disparities.
Keywords: pulmonary arterial hypertension, pediatric burden, Global burden of disease, health inequality, Disability-adjusted life years
Received: 20 Apr 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Tang, Wang and Wang. 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: Xinbao Wang, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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