In 2021, global COPD-associated heart failure cases exceeded 3.61 million, a 1.4-fold increase since 1990, with projections indicating continued increases in age-standardized prevalence and YLD rates through 2050, accompanied by substantial regional and sex-based heterogeneity.
Global COPD-associated heart failure cases exceeded 3.61 million in 2021, representing a 1.4-fold increase since 1990.
Age-standardized prevalence rates (ASPR) and age-standardized YLD rates (ASYR) increased overall from 1990 to 2021.
The burden of COPD-associated heart failure peaked at ages 70–74 and grew fastest among those aged 95 and older.
Regional burden varied substantially, with the Middle SDI region having the highest absolute case counts and East Asia having the highest regional burden.
Projections from 2022 to 2050 indicate continued global increases in both ASPR and ASYR, with slightly higher rises projected in females than males.
Sex-based differences in COPD-associated heart failure burden trends were identified, with absolute burden rising in both sexes but age-standardized rates moving in opposite directions.
This research suggests that the combination of chronic obstructive pulmonary disease (COPD) and heart failure represents a growing global health problem. By analyzing data from the Global Burden of Disease Study 2021, researchers found that more than 3.61 million people worldwide were living with COPD-associated heart failure in 2021 — roughly 1.4 times more than in 1990. The burden was not spread evenly: East Asia (particularly China) carried the heaviest absolute burden, older adults (especially those 70–74 years old) were most affected, and people aged 95 and older were the fastest-growing group experiencing this condition. The research also uncovered important differences between men and women. While total case numbers rose for both sexes, when adjusted for age and population size, rates were actually declining in men but rising in women. High-income regions were unusual in showing rising age-adjusted rates, while most other regions — especially Eastern Europe — saw declines. Projections using statistical modeling suggest this burden will continue to grow globally through 2050, with women potentially seeing slightly steeper increases than men. This research matters because COPD and heart failure together are more debilitating than either condition alone, placing a significant burden on patients' quality of life and on healthcare systems. The findings highlight that different regions, age groups, and sexes face very different trajectories, meaning that public health responses will need to be tailored accordingly. The authors call for coordinated international efforts and targeted prevention and management strategies to address this projected increase.
Liu C, Zhang H, Wang Z, Shi H, Chang L, Ruan Z, et al.. (2026). Global, Regional, and National Burden of Chronic Obstructive Pulmonary Disease-Associated Heart Failure: A Systematic Analysis of the Global Burden of Disease Study from 1990 to 2021 with Projections up to 2050.. International journal of chronic obstructive pulmonary disease. https://doi.org/10.2147/COPD.S628759