The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023

Xuan Yang; Zhen-Ping Zhao; Yu Shi; Gui-Yuan Han; Yan Xu; Yi-Chong Li; Mai-Geng Zhou

doi:10.1186/s40779-025-00650-y

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The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023

RESEARCH | Updated：2026-05-08

- The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023
- The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023
- Military Medical Research 2026年13卷第3期页码：413-425
- Affiliations：
  
  1.Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
  2.National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, Guangdong, China
  3.National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
  4.Clinical Research Center, Shenzhen Medical Academy of Research and Translation, Shenzhen 518048, Guangdong, China
- Author bio：
  
  * Yi-Chong Li yichongli.cvd@139.com
  Mai-Geng Zhou zhoumaigeng@ncncd.chinacdc.cn
- Funds：
  
  the National Key Research and Development Program of China (Noncommunicable Chronic Diseases-National Science and Technology Major Project)(2023ZD0503500);the Program for Guangdong Introducing Innovative and Entrepreneurial Teams(2019ZT08Y481);Shenzhen High-level Hospital Construction Fund, Shenzhen Clinical Research Center for Cardiovascular Disease Fund(20220819165348002);the National Clinical Research Center of Cardiovascular Diseases, Shenzhen(NCRCSZ-2024-001)
- DOI：10.1186/s40779-025-00650-y
  中图分类号：
- 收稿：2025-11-09，
  
  录用：2025-09-14，
  
  网络首发：2025-10-09，
  
  纸质出版：2026-03
- Accepted：
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Xuan Yang, Zhen-Ping Zhao, Yu Shi, 等. The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023[J]. Military Medical Research, 2026,13(3):413-425.

Xuan Yang, Zhen-Ping Zhao, Yu Shi, et al. The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023[J]. Military Medical Research, 2026, 13(3): 413-425.
Xuan Yang, Zhen-Ping Zhao, Yu Shi, 等. The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023[J]. Military Medical Research, 2026,13(3):413-425. DOI： 10.1186/s40779-025-00650-y.

Xuan Yang, Zhen-Ping Zhao, Yu Shi, et al. The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023[J]. Military Medical Research, 2026, 13(3): 413-425. DOI： 10.1186/s40779-025-00650-y.

摘要

Abstract

Background

Heart failure (HF) continues to be a public health issue in China with population aging and increasing disease drivers. The burden

spatial patterns

temporal trends

and underlying causes of HF in China at subnational lev-els remain inadequately understood. This study aims to assess the disease burden and causes of HF

and their regional disparities in China from 1990 to 2023.

Methods

Utilizing the estimates from the Global Burden of Diseases

Injuries

and Risk Factors Study (GBD) 2023

we assessed the prevalence and years lived with disability (YLDs) of HF and their trends in China at both national and subnational levels. Estimates were also compared by disease severity

sex

age group

cause

and region.

Results

In 2023

China had an estimated 14.3 million HF cases

marking a significant 208.4% increase over the past three decades. Ischemic heart disease (IHD) has become the top cause of HF

compared with 1990

with hypertensive heart disease (HHD) at the top. Alongside chronic obstructive pulmonary disease (COPD)

these three leading causes accounted for 77.4% of all HF cases. The burden of HF due to IHD and COPD exhibited distinct regional patterns and substantial disparities: regions in northern China exhibited notably higher age-standardized YLDs rates for HF due to IHD

while provinces in the western regions faced the highest burden from COPD. Six provinces with the highest tertile of YLDs rates in 2023 also experienced the most pronounced increases between 1990 and 2023.

Conclusions

HF remains a significant public health challenge in China

with a marked increase in prevalence over the past three decades. The substantial regional variations highlight the need for targeted and region-specific public health strategies. Enhanced nationwide efforts should be made to reduce the geographical disparities in the burden of HF.

关键词

Keywords

references

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