Chen Qin-Fen, Chen Lifen, Katsouras Christos S, Liu Chenyang, Shi Jingjing, Liang Dongjie, Xiang Guangze, Zhu Han, Liao Hetong, Lin Weihong, Zhou Xi, Zhou Xiao-Dong
Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 32500, China.
Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
Eur Heart J Qual Care Clin Outcomes. 2025 Jun 23;11(4):493-509. doi: 10.1093/ehjqcco/qcae110.
Heart failure (HF) presents a significant global health challenge due to its rising prevalence and impact on disability. This study aims to comprehensively analyse the global burden of HF and its underlying causes.
Using data from the Global Burden of Disease Study 2021, we analysed the prevalence and years lived with disability (YLD) of HF, examining its implications across diverse demographics and geographic regions. In 2021, approximately 55.5 million [95% uncertainty interval (UI) 49.0-63.8] people worldwide were affected by HF, a significant increase from 25.4 million (95% UI 22.3-29.2) in 1990. The age-standardized prevalence rate per 100 000 people was 676.7 (95% UI 598.7-776.8) overall, with males experiencing a higher rate at 760.8 (95% UI 673.2-874.7) compared to females at 604.0 (95% UI 535.0-692.3). The age-standardized prevalence YLD rates increased by 5.5% [95% confidence interval (CI) 2.7-8.5] and 5.9% (95% CI 2.9-9.0) during this period. Ischaemic heart disease emerged as the primary cause of HF, with an age-standardized prevalence rate of 228.3 (95% UI 118.2-279.6), followed by hypertensive heart disease at 148.3 (95% UI 117.3-186.3), and cardiomyopathy/myocarditis at 62.0 (95% UI 51.2-73.2). Noteworthy, countries in the high socio-demographic index (SDI) quintile exhibited higher HF prevalence rates but maintained stable trends. In contrast, countries in lower SDI quintiles, while initially experiencing lower prevalence rates, showed increased age-standardized HF prevalence and YLD rates over the same period.
HF emerges as a significant and growing public health challenge globally, influenced by distinct socioeconomic gradients.
心力衰竭（HF）因其患病率不断上升以及对残疾状况的影响，成为全球一项重大的健康挑战。本研究旨在全面分析HF的全球负担及其潜在病因。
利用《2021年全球疾病负担研究》的数据，我们分析了HF的患病率和伤残调整生命年（YLD），考察其在不同人口统计学特征和地理区域的影响。2021年，全球约有5550万人[95%不确定区间（UI）4900万 - 6380万]受HF影响，较1990年的2540万人（95% UI 2230万 - 2920万）有显著增加。每10万人的年龄标准化患病率总体为676.7（95% UI 598.7 - 776.8），男性患病率较高，为760.8（95% UI 673.2 - 874.7），而女性为604.0（95% UI 535.0 - 692.3）。在此期间，年龄标准化患病率YLD率分别上升了5.5%[95%置信区间（CI）2.7 - 8.5]和5.9%（95% CI 2.9 - 9.0）。缺血性心脏病成为HF的主要病因，年龄标准化患病率为228.3（95% UI 118.2 - 279.6），其次是高血压性心脏病，为148.3（95% UI 117.3 - 186.3），以及心肌病/心肌炎，为62.0（95% UI 51.2 - 73.2）。值得注意的是，社会人口指数（SDI）五分位数较高的国家HF患病率较高，但呈稳定趋势。相比之下，SDI五分位数较低的国家，虽然最初患病率较低，但在同一时期年龄标准化HF患病率和YLD率有所上升。
HF已成为全球一项重大且日益严峻的公共卫生挑战，受到不同社会经济梯度的影响。
