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. 2024 Feb 9;10(4):e26139.
doi: 10.1016/j.heliyon.2024.e26139. eCollection 2024 Feb 29.

International trends in pulmonary hypertension mortality between 2001 and 2019: Retrospective analysis of the WHO mortality database

Ping Lin  1 , Faming Jiang  1 , Xiaoqian Li  2 , Yuean Zhao  1 , Yujun Shi  3 , Zongan Liang  1
Affiliations

International trends in pulmonary hypertension mortality between 2001 and 2019: Retrospective analysis of the WHO mortality database

Ping Lin et al. Heliyon. .

Abstract

Background: There are limited published data on mortality trends in pulmonary hypertension (PH) worldwide. The objective of this study was to assess the PH-related mortality and time trends in the general population over the past 20 years.

Material and methods: We used country-level PH mortality data from the World Health Organization (WHO) mortality database (2000-19), using the International Classification of Diseases, tenth revision (ICD-10) codes (I27.0, I27.2, I27.8, or I27.9). The average annual percentage changes (AAPCs) were calculated to describe mortality trends.

Results: Fifty-four countries were included in this study. Between 2017 and 2019, the average age-standardized death rates (per 100,000) were 0.80 and 0.87 for males and females, respectively. Joinpoint analyses revealed a decreasing PH mortality trend for the overall population from 2000 to 2019 (AAPC -3.2 [95% confidence interval (CI) -4.1 to -2.4]), which was consistent between males and females (males: AAPC -5.3 [95% CI -6.2 to -4.4], females: AAPC -1.7 [95% CI -2.4 to -0.9]). When the estimates were stratified by etiology, we found that the mortality rates from idiopathic pulmonary arterial hypertension (I27.0) and pulmonary heart disease (unspecified, I27.9) had decreased significantly, while the mortality rates in other secondary PH (I27.2) and other specified pulmonary heart diseases (I27.8) had significantly increased. In addition, there were substantial differences in mortality rates and time trends across countries.

Conclusion: Although an overall decrease in PH mortality trends over the past two decades, there were substantial differences across countries. For countries with high or rising mortality rates, more efforts are needed to reduce the mortality.

Keywords: Mortality; Pulmonary hypertension; Temporal trend; WHO mortality database.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The 3-year (2017–19) average annual crude mortality (A) and age-standardized mortality (B) per 100,000 from PH.
Fig. 2
Fig. 2
The joinpoint regression analysis of PH mortality for the overall population (A) and etiologic classifications (B). APC, annual percentage change. *p values less than 0.05.
Fig. 3
Fig. 3
The AAPCs of PH mortality trends in males (A) and females (B) (*P values less than 0.05).
Fig. 4
Fig. 4
The LOESS line of best fit for age-specific mortality trends.
See this image and copyright information in PMC

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