{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:09:20Z","timestamp":1788797360359,"version":"build-2803163510"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary arterial hypertension (PAH) exhibits significant sex disparities; however, the impact on women aged \u226555\u202fyears\u2014a population-level proxy for postmenopausal women who experience substantial hormonal and cardiometabolic changes\u2014has not been comprehensively assessed. This research assessed long-term trends, regional variations, and structural factors influencing PAH in women aged \u226555\u202fyears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study utilizes standardized estimation data from GBD 2023, focusing on women aged 55\u202fyears and older as a population-level proxy for postmenopausal status. Joinpoint regression analysis was employed to investigate the trends in load. Decomposition analysis was utilized to measure the distinct impacts of population increase, aging, and epidemiological shifts. Frontier analysis was utilized to assess health output efficiency across different nations, while the ARIMA model was employed to forecast data until 2040.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2023, the Age-Standardized Incidence Rate (ASIR) showed a six-fold variation among nations (0.18\u20131.06 per 100,000), whilst the Age-Standardized Mortality Rate (ASMR) demonstrated almost a 160-fold disparity (0.007\u20131.13 per 100,000), with Central Asia and sub-Saharan Africa identified as high-burden hotspots. Between 1990 and 2023, global ASMR decreased by over 40%, while ASDR diminished by almost 35%. In persons aged 55\u202fyears and older, the age-specific incidence rate (ASIR) and age-specific prevalence rate (ASPR) for females were 1.3 to 1.8 times greater than those for males. Population growth accounted for 40\u201365% of the increases in burden in South Asia, East\/Southeast Asia, and Africa, while aging was the predominant factor in China and high-SDI regions. By 2040, global mortality and disability-adjusted life years (DALYs) are anticipated to persist in their decline, whereas incidence and prevalence are likely to stabilize; China\u2019s age-standardized incidence rate (ASIR) is forecasted to maintain a high plateau, while age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) will continue to diminish, exhibiting a steady trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reveals significant and enduring geographical disparities in the prevalence of PAH among women aged 55\u202fyears and older worldwide. Women aged 55\u201369\u202fyears represented the age group with the highest population-level incidence of PAH in the GBD estimates and may therefore warrant priority in surveillance and preventive strategies. High and middle SDI countries must swiftly establish long-term monitoring and chronic management systems specifically designed for women aged \u226555\u202fyears. Targeted policies and healthcare services are crucial for mitigating the global impact of PAH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1853948","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:24:53Z","timestamp":1788794693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Global burden and epidemiological determinants of pulmonary arterial hypertension among women aged 55\u202fyears and older: a GBD 2023 analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Guang-Wei","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Key Laboratory of Cardiovascular Disease of Yunnan Province, Clinical Medicine Center for Cardiovascular Disease of Yunnan Province, Yan\u2019an Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]},{"name":"Department of Cardiovascular Medicine, Anshun City People's Hospital","place":["Anshun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Cheng","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Long","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Key Laboratory of Cardiovascular Disease of Yunnan Province, Clinical Medicine Center for Cardiovascular Disease of Yunnan Province, Yan\u2019an Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s10554-017-1255-3","article-title":"Pulmonary vascular resistance and proper timing of percutaneous balloon mitral valvotomy","volume":"34","author":"Elmaghawry","year":"2018","journal-title":"Int J Cardiovasc Imaging"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2401324","DOI":"10.1183\/13993003.01324-2024","article-title":"Definition, classification and diagnosis of pulmonary hypertension","volume":"64","author":"Kovacs","year":"2024","journal-title":"Eur Respir J"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/s41418-024-01266-w","article-title":"SLC15A3 plays a crucial role in pulmonary fibrosis by 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