ArticlePulmonary circulation2026
Global Burden of Pulmonary Arterial Hypertension in Older Adults and Its Causal Association With Body Mass Index.
Article in Pulmonary circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
Pulmonary arterial hypertension (PAH) is a severe cardiopulmonary disease associated with substantial morbidity and mortality. However, the global burden, future trajectory, and potentially modifiable risk factors for PAH among older adults remain insufficiently characterized. This study aimed to quantify the global burden and projected trends of PAH among adults aged ≥ 60 years and investigate the causal association between body mass index (BMI) and PAH risk using Mendelian randomization (MR). We extracted PAH burden estimates from the Global Burden of Disease (GBD) 2021 study across 204 countries and territories, 21 GBD regions, and five socio-demographic index (SDI) strata. Temporal trends were assessed using age-standardized rates and average annual percent changes (AAPCs), while demographic decomposition and Bayesian age-period-cohort (BAPC) models were applied to evaluate drivers of burden changes and future trajectories. Two-sample MR analyses were performed using genome-wide significant BMI-associated genetic variants as instrumental variables and PAH genome-wide association study summary statistics from FinnGen. Between 1990 and 2021, global incident cases of PAH among adults aged ≥ 60 years increased from 6771.01 (95% uncertainty interval [UI]: 4577.81-9656.55) to 15,622.29 (95% UI: 10,546.44-22,296.65), and deaths increased from 6812.93 (95% UI: 5305.00-8473.04) to 15,443.42 (95% UI: 11,746.25-18,388.02). Although the age-standardized mortality, prevalence, and disability-adjusted life year (DALY) rates declined, the age-standardized incidence rate showed a slight increase (AAPC = 0.07%, 95% CI: 0.05-0.09). Marked geographic and SDI-related disparities were observed, with population growth and aging identified as the predominant contributors to the rising absolute burden. BAPC modeling projected continued increases in absolute PAH cases through 2050 despite declining age-standardized mortality and DALY rates. In addition, MR analyses provided suggestive evidence for a positive association between genetically predicted higher BMI and increased PAH risk (inverse-variance weighted odds ratio [IVW OR] = 1.84, 95% CI: 1.11-3.05,
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