Global, regional, and national trends in hypertensive heart disease burden due to high BMI: a 30-year analysis using GBD 2021 data with projections to 2035

Abstract

Background: High body mass index (BMI)-related hypertensive heart disease (HHD) is increasingly prevalent worldwide. Using Global Burden of Disease (GBD) 2021 data, we analyzed the changes in disability-adjusted life years (DALYs) and age-standardized rate (ASR) of mortality (ASMR) due to high BMI from 1990 to 2021. Methods: HHD data on high BMI were obtained from GBD 2021 at global, regional, and country levels. Age-standardized DALYs (ASDR) and deaths (ASMR) were calculated, with trends analyzed based on gender, age, and region. The autoregressive integrated moving average (ARIMA) model was used to project the burden through 2035, while the estimated annual percentage change (EAPC) was used to assess future trends. Results: From 1990 to 2021, global DALYs increased from 5.67 million to 12.55 million (a 1.81% rise in ASR), and deaths rose from 240,000 to 594,000. Men showed an 8.28% increase in DALYs, while women’s burden remained stable with a slight ASR decline. The highest burden was observed in those aged 80 and older, with DALYs increasing from 1243.80 to 1604.32. Projections suggest gradual decreases in DALYs and ASMR by 2035, although high BMI-related HHD remains a major public health concern. Conclusion: High BMI intensifies HHD prevalence, particularly among men and older adults. Despite projected minor decreases by 2035, rising obesity underscores the ongoing need for public health interventions.