The burden of hypertensive heart disease in China and G20 countries: analysis from 1990 to 2021 and 30-year projections for China

Background: Hypertensive heart disease (HHD) poses a major global public health challenge. This study provides updated estimates of the HHD burden in China and G20 countries from 1990 to 2021 and projects China's trends to 2051. Methods: Using data from the Global Burden of Disease 2021 study, we analyzed HHD prevalence, mortality, DALYs, and age-standardized rates (ASPR, ASDR) for China and G20 countries. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC). An ARIMA model projected China's incidence for 2021-2051. Results: In 2021, China reported 39.12 million HHD cases, 32.81 million deaths, and 55.89 million DALYs, with ASPR, ASDR, and DALY rates of 192.47, 18.85, and 292.54 per 100,000, respectively. G20 countries had 90.81 million cases, 89.67 million deaths, and 160.18 million DALYs, with corresponding rates of 139.64, 14.06, and 248.75 per 100,000. From 1990 to 2021, AAPCs for ASPR and ASDR showed no significant changes in China or G20 countries. China's rates consistently exceeded G20 averages, with no marked gender differences. Projections indicate a rising ASPR but slightly declining ASDR in China by 2051. Conclusion: Both China and the G20 group exhibit a pronounced upward trend in HHD prevalence and mortality, likely attributable to the backdrop of population aging. Conversely, China's declining prevalence and mortality rates may benefit from advances in medical technology. Furthermore, China's ASPR is projected to increase annually over the next 30 years. These findings underscore the imperative to strengthen prevention, control, and treatment strategies, providing crucial evidence for healthcare planning and practice.