Gender-specific prevalence and trend of heart failure in China from 1990 to 2019

Abstract

Aims: Heart failure (HF) is one of the leading causes of the global burden of disability and mortality. However, the comprehensive epidemic status of HF in China is unclear. Notably, the gender-specific survey for HF prevalence is lacking. The present study aimed to analyse the gender-specific prevalence and temporal trend of HF in China and explore the attributable aetiology and risk factors.

Methods and results: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 was used to evaluate the age-standardized prevalence and years lived with disability of HF in China by gender. The temporal trend of HF and attributable risk factors were analysed by Joinpoint regression models from 1990 to 2019. The total age-standardized prevalence rate of HF steadily decreased over the past two decades from 1079.4 to 1032.8 per 100 000 individuals. Since 2017, the prevalence trend of HF has significantly increased [annual percentage change (APC) of 2.72 for females and 0.61 for males, P < 0.05]. In 2019, the age-standardized rate of HF prevalence in females surpassed that of males, and hypertensive heart disease was the leading cause of HF for females (42.65% of cases) and males (41.19% of cases). From 2017 to 2019, high systolic pressure contributed to most cases of HF-related hypertensive heart disease, with an APC of 2.68 for females and 0.48 for males (P < 0.05).

Conclusions: Although HF prevalence has steadily decreased over the past two decades, an increasing trend has occurred since 2017, especially for females. The leading cause of HF was hypertensive heart disease. Metabolic risks, particularly high systolic pressure, consistently contribute to the prevalence of heart diseases leading to HF. Promoting HF screening and controlling metabolic risks at the population level are imperative. Gender differences in HF prevalence should be considered.

Keywords: China; Gender difference; Heart failure; Prevalence; Temporal trend.