AUTHOR=Xu Guorui , Feng Xiangyi , Qu Nini 

TITLE=Global, regional, and national burden of pulmonary arterial hypertension in adults aged ≥60 years from 1990–2021: SDI-stratified trend analysis and projections to 2050

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1595504

DOI=10.3389/fmed.2025.1595504

ISSN=2296-858X

ABSTRACT=BackgroundPulmonary arterial hypertension (PAH), a progressive and life-threatening condition, has significant implications for public health, particularly in the aging population. This study provides a comprehensive analysis of PAH in individuals aged 60 years and older from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021 study, which encompasses 204 countries and territories.MethodsWe tracked PAH trends (1990–2021) with three metrics: the annual percentage change (APC) from joinpoint, the average APC (AAPC) across segments, and the estimated APC (EAPC) from the log-linear model. APC captures year-by-year shifts; AAPC summarises the whole period; EAPC gives a single long-term slope. Significance set at 95% CI excluding zero. For 2022–2050 we used the Bayesian age-period-cohort (BAPC) model, which extends these time-component ideas into future projections.ResultsBetween 1990 and 2021, the number of new cases increased by 130%, deaths by 130%, and disability-adjusted life years (DALYs) increased by 100%. In 2021, there were 15,622 new cases, 15,443 deaths, and 248,064 DALYs globally. The incidence rate rose from 1.447 to 1.66 per 100,000 population. Looking ahead to 2050, we project the number of new cases to reach 31383 (95% CI: 17604.40, 45162.56), an incidence rate of 1.46 per 100,000, approximately 20,687 deaths, and 302,760 DALYs. In addition, Zambia recorded the highest incidence rate, while China had the largest total number of cases. The middle Sociodemographic Index (SDI) region bore the highest disease burden, highlighting disparities in the global distribution of PAH.ConclusionThese findings underscore the escalating burden of PAH among the elderly and emphasize the urgent need for targeted public health strategies to address this growing challenge. Our study highlights the importance of continued surveillance and the development of interventions to mitigate the impact of PAH on aging populations worldwide.