Sex, age, and socioeconomic determinants of pulmonary arterial hypertension burden in the Eastern Mediterranean

Abstract Background Pulmonary arterial hypertension (PAH; WHO Group 1 pulmonary hypertension) is a serious and progressive vascular disorder. Recent studies indicate that the global prevalence of PAH is rising. The burden of PAH in the Eastern Mediterranean Region (EMR) has not been well studied. Aims To examine the epidemiology and burden of PAH in the EMR from 1990 to 2021, comparing data by sex, age, location, and socio-demographic index (SDI). Study design Systematic analysis. Methods Data from the Global Burden of Disease 2021 (GBD 2021) was analyzed to evaluate incidence, prevalence, disability-adjusted life years (DALYs), and deaths for PAH. Accompanying 95% uncertainty intervals were provided and findings were presented as absolute counts and age-standardized rates. Results In 2021, the EMR reported 11.1 thousand prevalent cases and 3.4 thousand incident cases of PAH, with an age-standardized incidence rate (ASIR) of 0.5 per 100.000 and an age-standardized prevalence rate of 1.8. PAH contributed to more than 92,400 DALYs and was responsible for more than 1,800 deaths. The age-standardized DALYs rate and age-standardized death rate were 13.7 and 0.4, respectively. From 1990 to 2021, the age-standardized rates of all of the metrics decreased significantly. The disease was more prevalent among women than in men, with their incidence and prevalence peaking in the 75–79 age group. High SDI countries generally reported lower DALY and death rates. Conclusion The burden of PAH in the EMR varied by country, with older adults, especially women, facing higher incidence and death. To reduce the PAH burden, effective management is needed, including early diagnosis, improved treatment access, and preventive care.