The global burden of heart failure attributable to interstitial lung diseases: insights from the global burden of disease study 2021

Abstract

Background: The burden of interstitial lung disease (ILD)-associated heart failure (HF) poses a significant challenge to the prognosis of ILD patients. This study aimed to characterize the disease burden and analyse future trends of ILD-associated HF, offering valuable insights to inform targeted prevention and control strategies.

Methods: Data on the prevalence and years lived with disability (YLDs) of ILD-associated HF were retrieved from the Global Burden of Disease (GBD) database for the period 1990-2021. Trends in ILD-associated HF were evaluated using average annual percentage change (AAPC) and percentage change analyses. Future prevalence data were projected up to 2050 using predictive modelling.

Results: Globally, the number of patients with ILD-associated HF increased from 20,229 in 1990 to 104,059 in 2021, with the prevalence rising from 0.53 to 1.41 per 100,000 population. Prevalence rates were disproportionately higher in older populations, with individuals over 95 years experiencing a 17.78-fold increase over the study period. Additionally, a positive correlation was observed between higher socioeconomic development index (SDI) levels and ILD-associated HF prevalence. Among 204 countries, 71.1% exhibited an increasing trend in prevalence. However, Bayesian age-period-cohort (BAPC) modelling predicts a declining trend over the next 28 years.

Conclusion: Over the past three decades, the global burden of ILD-associated HF has escalated, particularly among individuals aged over 65 and in regions with high SDI levels. These findings underscore the need for region-specific, personalized intervention strategies to mitigate disease progression and enhance the quality of life for ILD patients.

Keywords: Global burden of disease; Heart failure; Interstitial lung diseases; Prediction; Prevalence.

Fig. 1

Time trend of the burden of ILD-associated HF by age group. (A) Prevalent cases of ILD-associated HF by age group globally from 1990 to 2021; (B) Prevalent cases of ILD-associated mild HF by age group globally from 1990 to 2021; (C) Prevalent cases of ILD-associated moderate HF by age group globally from 1990 to 2021; (D) Prevalent cases of ILD-associated severe HF by age group globally from 1990 to 2021; (E) The distribution of prevalent cases as percentages across different age groups globally, in five territories, and across 21 GBD regions in 1990 and 2021. Abbreviations: GBD, Global Burden of Disease; HF, heart failure; ILD, interstitial lung disease

Fig. 2

AAPC in age-specific prevalence rates and YLDs for ILD-associated HF by age groups and regions from 1990 to 2021. (A) AAPC of prevalence; (B) AAPC of YLDs. Abbreviations: AAPC, average annual percent change; HF, heart failure; ILD, interstitial lung disease; YLDs, years lived with disability

Fig. 3

Population-level changes in ageing, population growth, and epidemiologic factors for prevalence (A) and YLDs (B) across various SDI and GBD regions from 1990 to 2021. Black dots represent the overall change from all three components. Positive values indicate a positive contribution, whereas negative values indicate a negative contribution. Abbreviations: GBD, Global Burden of Disease; HF, heart failure; ILD, interstitial lung disease; SDI, Socio-demographic Index; YLDs, years lived with disability

Fig. 4

(A) Trends in the age-standardized prevalence of ILD-associated HF across 21 regions by SDI from 1990 to 2021; (B) Trends in the age-standardized prevalence of ILD-associated HF across 204 countries by SDI from 1990 to 2021. Abbreviations: HF, heart failure; ILD, interstitial lung disease; SDI, Socio-demographic Index

Fig. 5

Global trends in the burden of ILD-associated HF. (A) Age-standardized prevalence rate of ILD-associated HF across 204 countries in 2021; (B) AAPC in prevalence rates across 204 countries from 1990 to 2021. Abbreviations: AAPC, average annual percent change; HF, heart failure; ILD, interstitial lung disease