Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
ESC Heart Fail. 2023 Jun;10(3):1883-1895. doi: 10.1002/ehf2.14361. Epub 2023 Mar 26.
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.
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).
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.
心力衰竭（HF）是全球残疾和死亡率负担的主要原因之一。然而，中国 HF 的全面流行情况尚不清楚。特别是缺乏 HF 患病率的性别特异性调查。本研究旨在分析中国 HF 的性别特异性患病率和时间趋势，并探讨其可归因病因和危险因素。
使用 2019 年全球疾病、伤害和危险因素研究（Global Burden of Diseases, Injuries, and Risk Factors Study 2019），按性别评估中国 HF 的年龄标准化患病率和残疾年数。通过 Joinpoint 回归模型分析 1990 年至 2019 年 HF 的时间趋势和可归因危险因素。在过去的二十年中，HF 的总年龄标准化患病率稳步下降，从每 100000 人 1079.4 人下降到 1032.8 人。自 2017 年以来，HF 的患病率趋势明显增加[女性的年变化百分比（APC）为 2.72%，男性为 0.61%，P<0.05]。2019 年，女性 HF 的年龄标准化患病率超过男性，高血压性心脏病是女性（42.65%）和男性（41.19%）HF 的主要病因。2017 年至 2019 年，高收缩压导致大多数与 HF 相关的高血压性心脏病病例，女性的 APC 为 2.68%，男性为 0.48%（P<0.05）。
尽管 HF 的患病率在过去二十年中稳步下降，但自 2017 年以来呈上升趋势，尤其是女性。HF 的主要病因是高血压性心脏病。代谢风险，特别是高收缩压，一直是导致 HF 的心脏病患病率的主要原因。在人群层面上，促进 HF 筛查和控制代谢风险至关重要。应考虑 HF 患病率的性别差异。
