Global, Regional, and National Burden of Heart Failure Attributable to Chronic Obstructive Pulmonary Disease From 1990 to 2021, With Projections to 2050.

Objectives: Heart failure (HF), a common comorbidity of chronic obstructive pulmonary disease (COPD), is associated with an increased risk of death among patients with COPD. However, no systematic assessment has quantified the population-level burden of comorbid COPD and HF, worldwide. This study assessed the global, regional, and national HF burden attributable to COPD from 1990 to 2021 and projected this burden to 2050. Methods: Data on the non-fatal burden of COPD-attributable HF, including prevalence and years lived with disability (YLDs), were obtained from the Global Burden of Disease Study 2021. Temporal trends in age-standardized rates (ASRs) for COPD-attributable HF from 1990 to 2021 were examined using joinpoint models. Bayesian age-period-cohort models were used to project ASRs to 2050. Results: From 1990 to 2021, the absolute numbers of prevalent cases and YLDs for COPD-attributable HF increased globally, and the ASRs for prevalence and YLDs also increased. These upward trends were projected to continue to 2050. The burden of HF attributable to COPD was consistently higher in males than in females and higher in older adults than in younger individuals. By severity level, the burden of HF attributable to COPD was mainly driven by the treated and severe subtypes of HF. The burden varied substantially across regions, with low-socio-demographic index regions had the highest age-standardized burden. Conclusions: The global non-fatal burden of HF attributable to COPD was substantial from 1990 to 2021 and may continue to increase to 2050. Public health interventions targeting HF attributable to COPD may help reduce this burden.