Pediatric pulmonary arterial hypertension Deaths Drop by 58 Percent, But India Remains Worst-Hit: Study Reveals
China: In a recent global analysis published in Frontiers in Pediatrics, researchers led by Dr. Lili Deng from Kunming Children’s Hospital, China, have mapped the evolving burden of pediatric pulmonary arterial hypertension (PAH) across 204 countries from 1990 to 2021. The study, drawing on data from the Global Burden of Disease (GBD) database, reveals a mixed picture—marked overall improvements in mortality and disability burden, yet persistent regional disparities that highlight the pressing need for targeted action.
Pediatric PAH, a rare yet life-threatening condition, results from obstructive changes in the pulmonary vasculature that strain the right side of the heart. Unlike adult-onset PAH, its causes in children are often linked to congenital heart defects or developmental lung diseases such as bronchopulmonary dysplasia. While therapeutic advances have brought some relief in recent years, the disease continues to be underdiagnosed, especially in low-resource settings.
The study revealed the following findings:
- The global number of pediatric pulmonary arterial hypertension (PAH) cases has remained relatively stable from 1990 to 2021, though there has been a slight increase in absolute numbers.
- PAH-related deaths in children decreased by 57.66% over the three-decade period.
- Disability-adjusted life years (DALYs) linked to pediatric PAH declined by 63.59% globally during the same timeframe.
- These reductions indicate improvements in clinical recognition, early diagnosis, and treatment accessibility in various regions.
- Countries with lower Socio-Demographic Index (SDI) levels continue to bear the greatest burden of pediatric PAH.
- The highest prevalence and impact were recorded in South Asia, the Caribbean, and Sub-Saharan Africa.
- India, China, and Haiti reported the largest national burdens of pediatric PAH.
- In 2021, India recorded 295 pediatric deaths and more than 26,000 DALYs due to PAH, though both numbers nearly halved since 1990.
- High-middle SDI regions showed the most significant improvements, reflecting better healthcare infrastructure and specialist care availability.
- Low SDI regions still face major challenges, including limited diagnostic resources, lack of neonatal screening, and inadequate access to PAH-specific therapies.
Despite its valuable insights, the study acknowledges some limitations. The rarity of pediatric PAH and inconsistent data availability across countries necessitated statistical modeling, which may introduce uncertainty. Furthermore, aggregating all PAH types under a single category limits the ability to analyze differences based on disease subtypes.
To bridge the global care gap, the authors recommend key measures: establishing universal screening in early childhood, developing regional PAH registries to support data sharing, and creating mechanisms for pooled procurement of medications. These steps, they argue, are essential to ensuring that recent advances in PAH care translate into equitable outcomes for children everywhere.
The authors concluded, "While the global health community has made significant strides in managing pediatric PAH, addressing the persistent disparities will be vital to reducing its impact in the decades to come."
Reference:
Deng, L., Xiong, J., Xu, J., Li, Q., & Cheng, Z. (2025). Burden of pulmonary arterial hypertension in children globally, regionally, and nationally (1990–2021): Results from the global burden of disease study. Frontiers in Pediatrics, 13, 1527281. https://doi.org/10.3389/fped.2025.1527281
