Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada.
Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru.
Eur Heart J Qual Care Clin Outcomes. 2023 Nov 2;9(7):662-672. doi: 10.1093/ehjqcco/qcac088.
Heart failure (HF) is a global epidemic.
To assess global sex differences in HF epidemiology across country income levels.
Using Global Burden of Disease (GBD) data from 204 countries and territories 1990-2019, we assessed sex differences in HF prevalence, etiology, morbidity, and temporal trends across country sociodemographic index or gross national income. We derived age-standardized rates. Of 56.2 million (95% uncertainty interval [UI] 46.4-67.8 million) people with HF in 2019, 50.3% were females and 69.2% lived in low- and middle-income countries; age-standardized prevalence was greater in males and in high-income countries. Ischaemic and hypertensive heart disease were top causes of HF in males and females, respectively. There were 5.1 million (95% UI 3.3-7.3 million) years lived with disability, distributed equally between sexes. Between 1990 and 2019, there was an increase in HF cases, but a decrease in age-standardized rates per 100 000 in males (9.1%, from 864.2 to 785.7) and females (5.8%, from 686.0 to 646.1). High-income regions experienced a 16.0% decrease in age-standardized rates (from 877.5 to 736.8), while low-income regions experienced a 3.9% increase (from 612.1 to 636.0), largely consistent across sexes. There was a temporal increase in age-standardized HF from hypertensive, rheumatic, and calcific aortic valvular heart disease, and a decrease from ischaemic heart disease, with regional and sex differences.
Age-standardized HF rates have decreased over time, with larger decreases in males than females; and with large decreases in high-income and small increases in low-income regions. Sex and regional differences offer targets for intervention.
心力衰竭（HF）是一种全球性疾病。
评估全球不同性别在不同收入水平国家心力衰竭流行病学中的差异。
使用来自 204 个国家和地区的全球疾病负担（GBD）数据，我们评估了 1990-2019 年期间心力衰竭患病率、病因、发病率和时间趋势在国家社会人口指数或国民总收入方面的性别差异。我们得出了年龄标准化率。2019 年，5620 万人（95%不确定区间[UI]为 4640-6780 万人）患有心力衰竭，其中 50.3%为女性，69.2%生活在中低收入国家；年龄标准化患病率在男性和高收入国家中更高。缺血性和高血压性心脏病分别是男性和女性心力衰竭的主要病因。残疾生命年有 510 万人（95% UI 为 330-730 万人），在男女之间平分。1990 年至 2019 年间，心力衰竭病例有所增加，但男性（9.1%，从 864.2 降至 785.7）和女性（5.8%，从 686.0 降至 646.1）的年龄标准化率每 10 万人下降了。高收入地区的年龄标准化率下降了 16.0%（从 877.5 降至 736.8），而低收入地区则上升了 3.9%（从 612.1 升至 636.0），在性别之间基本一致。高血压、风湿性和钙化性主动脉瓣心脏病的年龄标准化 HF 呈上升趋势，缺血性心脏病呈下降趋势，存在区域和性别差异。
随着时间的推移，年龄标准化 HF 率有所下降，男性下降幅度大于女性；高收入地区下降幅度较大，低收入地区上升幅度较小。性别和区域差异为干预提供了目标。
