Yang Yicheng, Zeng Zhiwei, Yang Qiaoxi, Wang Huan, Zhang Hanwen, Yan Wenjie, Wang Peizhi, Wang Chuangshi, Su Zhanhao, Thangaraju Pugazhenthan, Safi Sher Zaman, Yang Beilan, Wang Yaoyao, Zhou Jingjing, Zou Zhiyong, Huang Yuan, Shu Songren, Xiong Changming
State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Center of Respiratory and Pulmonary Vascular Disease Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
MedComm (2020). 2025 Apr 24;6(5):e70175. doi: 10.1002/mco2.70175. eCollection 2025 May.
Pulmonary arterial hypertension (PAH) poses significant clinical management challenges due to gaps in understanding its global epidemiology. We analyzed PAH-related disability-adjusted life years (DALYs), deaths, and prevalence from 1990 to 2021. Age-period-cohort models and regression analyses assessed temporal trends and projected burdens to 2050. Globally, PAH-related DALYs declined by 6.6%, but increased by 13.9% in high socio-demographic index (SDI) countries. Middle SDI regions reported the highest DALYs in 1990 and 2021. Deaths rose by 48.5% worldwide, with high SDI nations experiencing a 76.6% surge. Age-standardized rates (ASRs) of DALYs and deaths decreased across SDI countries, with high-middle SDI regions showing the steepest declines. Younger age groups, especially males, had a higher proportion of global DALYs in earlier years, but the burden shifted toward older populations over time, with this trend more pronounced in high-SDI countries. Age-period-cohort analysis revealed declining DALYs in younger ages but rising rates in older cohorts. By 2050, deaths and prevalence are projected to rise, disproportionately affecting females. Significant regional disparities in PAH burden persist, necessitating targeted policies, improved healthcare access, and early detection strategies, especially in underserved areas. Addressing these disparities is critical for mitigating PAH' s global impact.
由于对肺动脉高压（PAH）全球流行病学的认识存在差距，其临床管理面临重大挑战。我们分析了1990年至2021年与PAH相关的伤残调整生命年（DALYs）、死亡人数和患病率。年龄-时期-队列模型和回归分析评估了时间趋势，并预测了到2050年的疾病负担。在全球范围内，与PAH相关的DALYs下降了6.6%，但在社会人口统计学指数（SDI）较高的国家增加了13.9%。中等SDI地区在1990年和2021年报告的DALYs最高。全球死亡人数上升了48.5%，高SDI国家激增了76.6%。SDI国家中DALYs和死亡的年龄标准化率（ASRs）均有所下降，中高SDI地区下降最为显著。早年，较年轻年龄组，尤其是男性，在全球DALYs中所占比例较高，但随着时间的推移，负担向老年人群转移，这一趋势在高SDI国家更为明显。年龄-时期-队列分析显示，年轻年龄段的DALYs下降，但老年队列的发病率上升。预计到2050年，死亡人数和患病率将上升，对女性的影响尤为严重。PAH负担存在显著的地区差异，需要制定针对性政策、改善医疗服务可及性并采取早期检测策略，尤其是在服务不足的地区。解决这些差异对于减轻PAH的全球影响至关重要。
