Open Access

ARTICLE

Global Trends, Health Inequalities, and Relationship with Socio-Demographic Index in Congenital Heart Disease: An Analysis from 1990 to 2021

Jingdong Qi^1,#, Fei Zhang^1,#, Xia Zhang^2,*

1 Department of Intensive Care Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, 211200, China
2 Department of Respiratory Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, 211200, China

* Corresponding Author: Xia Zhang. Email:
# These authors contributed equally to this work

Congenital Heart Disease 2025, 20(3), 383-400. https://doi.org/10.32604/chd.2025.064790

Received 24 February 2025; Accepted 20 June 2025; Issue published 11 July 2025

Abstract

Background: Congenital heart disease (CHD) remains a significant global health concern, with considerable heterogeneity across age groups, genders, and regions. Objective: This study aimed to investigate the global epidemiological patterns, inequalities, and socio-demographic determinants of CHD burden from 1990 to 2021 to inform targeted interventions. Methods: This study aimed to investigate the global epidemiological patterns, inequalities, and socio-demographic determinants of CHD burden from 1990 to 2021 to inform targeted interventions. Results: CHD burden increased with age, peaking among individuals aged 70 years and older. This does not reflect new-onset disease, but rather the accumulation of late diagnoses, long-term complications, and healthcare encounters in aging individuals with CHD. Males consistently exhibited higher incidence and mortality rates than females. From 1990 to 2010, global age-standardized prevalence and incidence rates increased steadily and declined slightly thereafter. Joinpoint and age-period-cohort analyses revealed inflection points post-2010 and suggested cohort-related effects. Although SII trends indicated rising inequality over time, that disease burden has become more concentrated in low-SDI regions. ARIMA projections estimated a stable or marginally declining CHD burden by 2030. Regional analyses showed that high-SDI countries experienced significant reductions in CHD mortality, whereas low-SDI regions continued to bear a disproportionate burden. Conclusions: CHD burden has shifted in recent decades, influenced by demographic transitions, healthcare access, and socio-economic development. Despite progress, persistent health inequalities remain. Continued investment in early detection, maternal care, and public health infrastructure is essential to reduce CHD disparities globally.

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