Heart failure in China: a macroeconomic modelling study of intervention strategies

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http://eprints.org/relation/isVersionOf https://pure.iiasa.ac.at/id/document/112084 http://eprints.org/relation/isVolatileVersionOf https://pure.iiasa.ac.at/id/document/112084 http://eprints.org/relation/issmallThumbnailVersionOf https://pure.iiasa.ac.at/id/document/112084 archive 353 disk0/00/02/10/66 2025-12-09 09:54:34 2026-02-24 13:22:06 2025-12-09 09:54:34 article show Wang H. Zhou H. Chai K. Yan S. Liu Y. Kuhn M. 2235 Prettner K. Cao Z. Du M. Wang T. Zeng P. Wu J. Chen S. Yang J. Heart failure in China: a macroeconomic modelling study of intervention strategies pub EF B-type natriuretic peptide; Cost-benefit interventions; Guideline-directed medical therapy; Heart failure; Macroeconomic burden Background and Aims Heart failure (HF) imposes a growing public health and macroeconomic burden in low- and middle-income countries (LMICs), yet its long-term economic impact remains unquantified. China, characterized by rapid ageing and escalating cardiovascular risks, provides a critical setting to model HF economic implications. Methods Using data from the Global Burden of Disease Study 2021, China Cardiovascular Association Registry, and national insurance databases, HF macroeconomic burden (2025–35) was projected via a health-augmented macroeconomic model. Three interventions were evaluated: B-type natriuretic peptide (BNP) screening (adults ≥40 years), intensive blood pressure (BP) control (hypertensive patients), and guideline-directed medical therapy (GDMT) optimization for HF with reduced ejection fraction. Costs are reported in 2017 international dollars (INT$). Results By 2035, HF cases in China will reach 22.7 million [95% uncertainty interval (UI): 9.5–36.9 million], with an age-standardized prevalence of 760.65/100 000 (95% UI: 283.2–1340.8/100 000). The cumulative economic burden (2025–35) is INT$1001.1 billion (95% UI: 733.4–1365.6 billion), representing 0.26% of gross domestic product (95% UI: 0.19%–0.34%), driven by labour force attrition (72.1%; 95% UI: 64.4%–74.8%). Interventions reduced the total burden by 12.5% (95% UI: 10.4%–14.5%): BNP screening (25% coverage) saved INT$78.5 billion (95% UI: 62.8–94.1 billion; 8.10% reduction; cost-benefit ratio 0.49), Intensive BP control saved INT$27.5 billion (95% UI: 25.1–29.9 billion; 2.74% reduction; ratio 0.22), GDMT optimization saved INT$17.0 billion (95% UI: 12.8–22.4 billion; 1.70% reduction; ratio 0.48). Conclusions HF imposes a substantial and increasing macroeconomic burden in China, largely through workforce productivity losses. Scalable, cost-effective strategies, including primary care-based BNP screening, subsidized hypertension control, and enhanced GDMT adherence, are essential to curb economic losses. These findings inform policy priorities for China and other LMICs confronting demographic transitions. 2026-02 published Oxford Academic doi:10.1093/eurheartj/ehaf992 3124 public European Heart Journal 47 8 974-984 TRUE 0195-668X info:eu-repo/semantics/article