{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:04:23Z","timestamp":1784657063350,"version":"3.55.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["No. JCGZZ2023076"],"award-info":[{"award-number":["No. JCGZZ2023076"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020208","name":"Shanghai Minhang District Health Commission","doi-asserted-by":"publisher","award":["No. 2024LM01"],"award-info":[{"award-number":["No. 2024LM01"]}],"id":[{"id":"10.13039\/501100020208","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic respiratory diseases (CRDs) and heart failure (HF) impose substantial global burdens. However, the long-term population-level burden of HF impairment under CRD cause categories remains insufficiently characterized within the GBD framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using GBD 2021 data, we estimated the prevalence and years lived with disability (YLDs) of HF impairment under CRD cause categories among adults aged \u226555 years from 1990 to 2021. CRD cause categories included chronic obstructive pulmonary disease (COPD), interstitial lung disease and pulmonary sarcoidosis (ILD&amp;PS), and pneumoconiosis (PC). Cases, rates, relative changes, and EAPCs were used as primary descriptive measures. Joinpoint regression, age\u2013period\u2013cohort analysis, inequality indices, and BAPC-based projections were used as secondary analyses to describe trend timing, age\u2013cohort patterns, socioeconomic distribution, and historical-trend extensions through 2032.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2021, the global prevalent cases and YLDs of HF impairment under CRD cause categories increased markedly, while prevalence and YLD rates changed only modestly overall. The burden rose sharply with age, especially after age 75, and was generally higher in males. Temporal trends differed across periods. Patterns varied across SDI strata and differed by CRD subtype. Model-based extensions of historical patterns suggested that this burden pattern may remain substantial through 2032.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The burden of HF impairment under CRD cause categories showed marked population-level variation across age, sex, SDI strata, and CRD subtypes. These findings may help inform burden monitoring, public health planning, resource allocation, and long-term service planning for older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0353177","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:26:52Z","timestamp":1784654812000},"page":"e0353177","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global patterns and trends in heart failure burden under chronic respiratory disease cause categories among adults aged 55 years and older: A systematic analysis based on the GBD 2021 Study"],"prefix":"10.1371","volume":"21","author":[{"given":"Yinqin","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anran","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZhenYi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaobin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3647-6185","authenticated-orcid":true,"given":"Hong","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"pone.0353177.ref001","doi-asserted-by":"crossref","first-page":"101936","DOI":"10.1016\/j.eclinm.2023.101936","article-title":"Global burden of chronic respiratory diseases and risk factors, 1990\u20132019: an update from the Global Burden of Disease Study 2019","volume":"59","author":"S Momtazmanesh","year":"2023","journal-title":"eClinicalMedicine"},{"issue":"5","key":"pone.0353177.ref002","doi-asserted-by":"crossref","first-page":"3264","DOI":"10.1002\/ehf2.14915","article-title":"Global trends in heart failure from 1990 to 2019: an age-period-cohort analysis from the Global Burden of Disease study","volume":"11","author":"Z Liu","year":"2024","journal-title":"ESC Heart Fail"},{"key":"pone.0353177.ref003","article-title":"2026 heart disease and stroke statistics: a report of US and global data from the American Heart Association","author":"LP Palaniappan","year":"2026","journal-title":"Circulation"},{"issue":"1","key":"pone.0353177.ref004","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1161\/CIRCULATIONAHA.117.027551","article-title":"Trends in hospitalizations and survival of acute decompensated heart failure in four US Communities (2005-2014): ARIC study community surveillance","volume":"138","author":"PP Chang","year":"2018","journal-title":"Circulation"},{"issue":"3","key":"pone.0353177.ref005","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1038\/s41591-021-01659-1","article-title":"The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial","volume":"28","author":"AA Voors","year":"2022","journal-title":"Nat Med"},{"issue":"1","key":"pone.0353177.ref006","doi-asserted-by":"crossref","DOI":"10.52225\/narra.v5i1.1833","article-title":"Redefining treatment paradigms: Early use of dapagliflozin and empagliflozin in acute heart failure - a systematic review and meta-analysis of randomized controlled trials","volume":"5","author":"SS Immanuel","year":"2025","journal-title":"Narra J"},{"issue":"10120","key":"pone.0353177.ref007","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0140-6736(17)32520-5","article-title":"Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals","volume":"391","author":"N Conrad","year":"2018","journal-title":"Lancet"},{"key":"pone.0353177.ref008","doi-asserted-by":"crossref","first-page":"20406223251314286","DOI":"10.1177\/20406223251314286","article-title":"Biological pathways and mechanisms linking COPD and cardiovascular disease","volume":"16","author":"B Ragnoli","year":"2025","journal-title":"Ther Adv Chronic Dis"},{"issue":"4","key":"pone.0353177.ref009","article-title":"The interplay of heart failure and lung disease: clinical correlations, mechanisms, and therapeutic implications","volume":"1","author":"S Ahmad","year":"2024","journal-title":"J Respir Biol Transl Med"},{"issue":"8","key":"pone.0353177.ref010","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1161\/CIRCULATIONAHA.116.022362","article-title":"Systemic consequences of pulmonary hypertension and right-sided heart failure","volume":"141","author":"S Rosenkranz","year":"2020","journal-title":"Circulation"},{"key":"pone.0353177.ref011","first-page":"199","article-title":"Hypoxemia in patients with COPD: cause, effects, and disease progression","volume":"6","author":"BD Kent","year":"2011","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"13","key":"pone.0353177.ref012","doi-asserted-by":"crossref","first-page":"4774","DOI":"10.3390\/jcm14134774","article-title":"The complex relationship between heart failure and chronic obstructive pulmonary disease: a comprehensive review","volume":"14","author":"LE Corneanu","year":"2025","journal-title":"J Clin Med"},{"key":"pone.0353177.ref013","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.2147\/COPD.S145599","article-title":"Hyperinflated lungs compress the heart during expiration in COPD patients: a new finding on dynamic-ventilation computed tomography","volume":"12","author":"Y Xu","year":"2017","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"4","key":"pone.0353177.ref014","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.arbres.2024.01.013","article-title":"Multidisciplinary management of patients with chronic obstructive pulmonary disease and cardiovascular disease","volume":"60","author":"J de Miguel-Diez","year":"2024","journal-title":"Arch Bronconeumol"},{"issue":"370","key":"pone.0353177.ref015","first-page":"1","article-title":"Health characteristics of adults 55 years of age and over: United States, 2000-2003","author":"CA Schoenborn","year":"2006","journal-title":"Adv Data"},{"issue":"18","key":"pone.0353177.ref016","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1016\/j.ehj.2004.06.038","article-title":"Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study","volume":"25","author":"GS Bleumink","year":"2004","journal-title":"Eur Heart J"},{"issue":"7","key":"pone.0353177.ref017","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1093\/eurjpc\/zwae384","article-title":"Temporal trend and attributable risk factors of cardiovascular disease burden for adults 55 years and older in 204 countries\/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021","volume":"32","author":"M-S Wang","year":"2025","journal-title":"Eur J Prev Cardiol"},{"issue":"10440","key":"pone.0353177.ref018","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"GBD Diseases","year":"2024","journal-title":"Lancet"},{"issue":"9859","key":"pone.0353177.ref019","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"T Vos","year":"2012","journal-title":"Lancet"},{"issue":"10258","key":"pone.0353177.ref020","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(20)30977-6","article-title":"Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Collaborators G B D D","year":"2020","journal-title":"Lancet"},{"issue":"15","key":"pone.0353177.ref021","doi-asserted-by":"crossref","first-page":"19614","DOI":"10.18632\/aging.203374","article-title":"Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019","volume":"13","author":"X Yang","year":"2021","journal-title":"Aging (Albany NY)"},{"issue":"1","key":"pone.0353177.ref022","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1080\/07853890.2022.2074535","article-title":"Global, regional and national burden of gastroesophageal reflux disease, 1990-2019: update from the GBD 2019 study","volume":"54","author":"D Zhang","year":"2022","journal-title":"Ann Med"},{"issue":"2","key":"pone.0353177.ref023","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2024-005383","article-title":"Global, regional and national trends in the epidemiology of rheumatoid arthritis from 1990 to 2021: an age-period-cohort effect analysis of the global burden of disease study 2021","volume":"11","author":"K Tang","year":"2025","journal-title":"RMD Open"},{"issue":"1","key":"pone.0353177.ref024","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1136\/ard-2023-224530","article-title":"Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990-2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019","volume":"83","author":"F Cao","year":"2024","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"pone.0353177.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0238871","article-title":"Clarifying assumptions in age-period-cohort analyses and validating results","volume":"15","author":"R Masters","year":"2020","journal-title":"PLoS One"},{"key":"pone.0353177.ref026","doi-asserted-by":"crossref","first-page":"102124","DOI":"10.1016\/j.arr.2023.102124","article-title":"Global, regional, and national prevalence of hearing loss from 1990 to 2019: A trend and health inequality analyses based on the Global Burden of Disease Study 2019","volume":"92","author":"C-Y Jiang","year":"2023","journal-title":"Ageing Res Rev"},{"issue":"6","key":"pone.0353177.ref027","doi-asserted-by":"crossref","first-page":"103326","DOI":"10.1016\/j.autrev.2023.103326","article-title":"Global burden and cross-country inequalities in autoimmune diseases from 1990 to 2019","volume":"22","author":"F Cao","year":"2023","journal-title":"Autoimmun Rev"},{"issue":"1","key":"pone.0353177.ref028","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1093\/ije\/dyaa196","article-title":"Global trend of aetiology-based primary liver cancer incidence from 1990 to 2030: a modelling study","volume":"50","author":"Z Liu","year":"2021","journal-title":"Int J Epidemiol"},{"key":"pone.0353177.ref029","doi-asserted-by":"crossref","first-page":"04142","DOI":"10.7189\/jogh.14.04142","article-title":"Global burden and attributable risk factors of breast cancer in young women: historical trends from 1990 to 2019 and forecasts to 2030 by sociodemographic index regions and countries","volume":"14","author":"M Yuan","year":"2024","journal-title":"J Glob Health"},{"issue":"1","key":"pone.0353177.ref030","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12978-025-02013-1","article-title":"Rising global burden of common gynecological diseases in women of childbearing age from 1990 to 2021: an update from the Global Burden of Disease Study 2021","volume":"22","author":"Y Gao","year":"2025","journal-title":"Reprod Health"},{"key":"pone.0353177.ref031","volume-title":"World Population Ageing 2023: Challenges and opportunities of population ageing in the least developed countries","author":"United Nations Department of Economic and Social Affairs, Population Division","year":"2023"},{"issue":"5","key":"pone.0353177.ref032","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1111\/jgs.14868","article-title":"Effect of chronic diseases and multimorbidity on survival and functioning in elderly adults","volume":"65","author":"D Rizzuto","year":"2017","journal-title":"J Am Geriatr Soc"},{"issue":"11","key":"pone.0353177.ref033","article-title":"Chronic obstructive pulmonary disease exacerbations increase the risk of subsequent cardiovascular events: a longitudinal analysis of the COPDGene Study","volume":"13","author":"H-M Yang","year":"2024","journal-title":"J Am Heart Assoc"},{"issue":"11","key":"pone.0353177.ref034","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1164\/rccm.202509-2272ED","article-title":"The case for case-finding in asthma and chronic obstructive pulmonary disease","volume":"211","author":"JA Krishnan","year":"2025","journal-title":"Am J Respir Crit Care Med"},{"issue":"606","key":"pone.0353177.ref035","doi-asserted-by":"crossref","DOI":"10.3399\/bjgp13X660788","article-title":"Case finding for chronic obstructive pulmonary disease in primary care: a pilot randomised controlled trial","volume":"63","author":"S Haroon","year":"2013","journal-title":"Br J Gen Pract"},{"issue":"21","key":"pone.0353177.ref036","doi-asserted-by":"crossref","first-page":"697","DOI":"10.15585\/mmwr.mm7121a1","article-title":"Barriers to and disparities in access to health care among adults aged \u226518 years with epilepsy - United States, 2015 and 2017","volume":"71","author":"N Tian","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"20","key":"pone.0353177.ref037","first-page":"1","article-title":"Age adjustment using the 2000 projected U.S. population","author":"RJ Klein","year":"2001","journal-title":"Healthy People 2010 Stat Notes"},{"key":"pone.0353177.ref038","doi-asserted-by":"crossref","DOI":"10.2471\/B09466","volume-title":"WHO report on the global tobacco epidemic, 2025: warning about the dangers of tobacco","author":"World Health Organization","year":"2025"},{"issue":"18","key":"pone.0353177.ref039","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology\/American heart association joint committee on clinical practice guidelines","volume":"145","author":"PA Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"pone.0353177.ref040","article-title":"Ageing, demographics, and heart failure","volume":"21","author":"AJS Coats","year":"2019","journal-title":"Eur Heart J Suppl"},{"issue":"5","key":"pone.0353177.ref041","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S2213-2600(16)30424-6","article-title":"Occupational lung diseases: from old and novel exposures to effective preventive strategies","volume":"5","author":"P Cullinan","year":"2017","journal-title":"Lancet Respir Med"},{"key":"pone.0353177.ref042","doi-asserted-by":"crossref","first-page":"101860","DOI":"10.1016\/j.eclinm.2023.101860","article-title":"Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis","volume":"57","author":"SR Chowdhury","year":"2023","journal-title":"EClinicalMedicine"},{"key":"pone.0353177.ref043","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ijcard.2020.01.003","article-title":"Heart failure with preserved ejection fraction: similarities and differences between women and men","volume":"304","author":"CJ Pepine","year":"2020","journal-title":"Int J Cardiol"},{"key":"pone.0353177.ref044","doi-asserted-by":"crossref","first-page":"379","DOI":"10.2147\/COPD.S263031","article-title":"Pulmonary rehabilitation in a post-COVID-19 world: telerehabilitation as a new standard in patients with COPD","volume":"16","author":"M Tsutsui","year":"2021","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"3","key":"pone.0353177.ref045","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3390\/ijerph14030269","article-title":"Mortality in miners with coal-workers\u2019 pneumoconiosis in the czech republic in the period 1992-2013","volume":"14","author":"H Tom\u00e1\u0161kov\u00e1","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0353177.ref046","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.clinimag.2022.11.005","article-title":"Two in one: Overlapping CT findings of COVID-19 and underlying lung diseases","volume":"93","author":"G Durhan","year":"2023","journal-title":"Clin Imaging"},{"key":"pone.0353177.ref047","unstructured":"GOLD. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2025 report). 2024."},{"issue":"4","key":"pone.0353177.ref048","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.shaw.2024.08.005","article-title":"Trends in exposure to respirable dust and respirable crystalline silica among lithium mine workers in Western Australia","volume":"15","author":"D Gbondo","year":"2024","journal-title":"Saf Health Work"},{"issue":"1","key":"pone.0353177.ref049","article-title":"Time to diagnosis of idiopathic pulmonary fibrosis in the IPF-PRO Registry","volume":"7","author":"LD Snyder","year":"2020","journal-title":"BMJ Open Respir Res"},{"key":"pone.0353177.ref050","doi-asserted-by":"crossref","first-page":"739674","DOI":"10.1155\/2014\/739674","article-title":"Pulmonary hypertension and right heart dysfunction in chronic lung disease","volume":"2014","author":"A Zangiabadi","year":"2014","journal-title":"Biomed Res Int"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0353177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:27:04Z","timestamp":1784654824000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0353177"}},"subtitle":[],"editor":[{"given":"Harapan","family":"Harapan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":50,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0353177","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]}}}