Fang Zhang, Luo Xiaofang, Zhang Yuhui, Zhang Jian
State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Key Laboratory of Clinical Research for Cardiovascular Medications, National Health Committee, Beijing, China.
Int J Cardiol Cardiovasc Risk Prev. 2025 Aug 22;27:200497. doi: 10.1016/j.ijcrp.2025.200497. eCollection 2025 Dec.
Heart failure (HF) represents a major global public health challenge. This study aims to report the HF prevalence and disability in mainland China from 1990 to 2021, as well as the underlying etiology.
Data on HF-related prevalence and years lived with disability (YLDs) were obtained from Global Burden of Disease 2021 study for mainland China. Analyses were conducted by age and sex, with the burden rates expressed per 100,000 population. Age-period-cohort models were used to describe the trajectory of HF during 1990-2021. We analyzed the potential etiologies of HF, and performed decomposition analysis to quantify the main drivers of changes in the burden.
In 2021, the prevalence and YLDs rates of HF in mainland China were 920.7 per 100,000 population (95 % uncertainty interval [UI]: 795.7-1080.8) and 90.7 per 100,000 population (95 % UI: 60.9-124.8), respectively. Both the prevalence and YLDs rates were higher in males than in females. From 1990 to 2021, the crude prevalence rate and crude YLDs rate of HF consistently increased, while the age-standardized prevalence rate and age-standardized rate of YLDs exhibited an double-peak trend. By 2021, ischemic heart disease had surpassed hypertensive heart disease as the leading cause of HF prevalence. Population aging was the largest contributor to changes in HF burden.
Our analysis of the GBD 2021 study indicated that the burden of HF is projected to increase substantially with an aging population. Strengthened societal efforts are urgently needed to prevent and manage HF from its causes, with particular attention to older adults.
心力衰竭（HF）是一项重大的全球公共卫生挑战。本研究旨在报告1990年至2021年中国大陆心力衰竭的患病率和伤残情况，以及潜在病因。
从《2021年全球疾病负担研究》中获取中国大陆与心力衰竭相关的患病率和伤残调整生命年（YLDs）数据。按年龄和性别进行分析，负担率以每10万人表示。采用年龄-时期-队列模型描述1990 - 2021年期间心力衰竭的发展轨迹。我们分析了心力衰竭的潜在病因，并进行分解分析以量化负担变化的主要驱动因素。
2021年，中国大陆心力衰竭的患病率和YLDs率分别为每10万人920.7例（95%不确定区间[UI]：795.7 - 1080.8）和每10万人90.7例（95% UI：60.9 - 124.8）。男性的患病率和YLDs率均高于女性。1990年至2021年，心力衰竭的粗患病率和粗YLDs率持续上升，而年龄标准化患病率和年龄标准化YLDs率呈现双峰趋势。到2021年，缺血性心脏病已超过高血压性心脏病，成为心力衰竭患病率的主要原因。人口老龄化是心力衰竭负担变化的最大贡献因素。
我们对《2021年全球疾病负担研究》的分析表明，随着人口老龄化，心力衰竭的负担预计将大幅增加。迫切需要加强社会力量，从病因上预防和管理心力衰竭，尤其要关注老年人。
