22 February 2021

The Global Burden of Pulmonary Hypertension

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Pulmonary Arterial Hypertension identified as a major contributor to right heart failure

The Global Burden of Disease (GBD) study is the most comprehensive worldwide epidemiological study of the changing health challenges facing people across the world. Led by the Institute for Health Metrics and Evaluation (IHME), it offers a powerful resource and an important tool to inform clinicians, researchers, and policymakers worldwide.

In 2020, pulmonary arterial hypertension (PAH) was distinguished as its own cause of right heart failure within the GBD study. This was reported in the latest issue (October 2020) of The Lancet’s special issue on GBD which includes a systematic analysis of the global burden of 369 diseases, which cites PAH as a new cause added to the GBD modelling framework. The first report to include PAH data will be available forthcoming update in Spring 2021.

The forthcoming iteration of the study will report prevalence, incidence, and mortality rates of PAH. This includes identifying all population-representative estimates of PAH; estimating and correcting systematic bias in data sources; and using statistical models to identify geographical trends, temporal trends, and relationships between PAH and covariates.

While causes of right heart failure were previously modelled in GBD, PAH as a specific cause was not. Such an omission can lead to an incorrect assumption that PAH has low prevalence as a cause. As reported by Sophia Emmons-Bell from the IHME at the recent PVRI webinar on the global burden of pulmonary hypertension, estimates show that in 2020 there were 1.92 million cases of RHF, 373,000 of which were contributed by PAH.

This represents a major step in the identification of PAH as a significant cause of right heart failure and a global disease burden.

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