Objective To analyze the burden, trends, health inequalities, and future projections of heart failure in Asia from 1990 to 2023 based on the Global Burden of Disease (GBD) 2023 study.

Methods Age-standardized prevalence rates (ASPR) and age-standardized Years Lived with Disability (YLDs) rates were calculated. Joinpoint regression, Age-Period-Cohort (APC) models, Das Gupta decomposition analysis, Data Envelopment Analysis (DEA), Slope Index of Inequality (SII), Concentration Index (CI), and Bayesian Age-Period-Cohort (BAPC) models were employed.

Results In 2023, approximately 30.29 million (95% uncertainty intervals [UI]: 23.66–37.99 million) heart failure cases occurred in Asia, with an ASPR of 602.603 per 100,000 (95% UI: 471.499–754.961). YLDs totaled 2.92 million (95% UI: 1.89–4.26 million), with an age-standardized YLDs rate of 57.970 per 100,000 (95% UI: 37.575–84.627). From 1990 to 2023, ASPR increased with an estimated annual percentage change (EAPC) of 0.252% (95% CI: 0.231–0.273) and the age-standardized YLDs rate increased with an EAPC of 0.238% (95% CI: 0.219–0.257). East Asia had the highest ASPR (674.809 per 100,000) and YLDs rate (65.802 per 100,000). Males had higher ASPR and YLDs rates than females across all subregions. Decomposition analysis showed that aging (49.04%) and population growth (41.80%) were the primary drivers of burden increase. SII deteriorated from 10.684 in 1990 to 25.003 in 2023 (134.0% increase), and CI declined from −0.077 to −0.229, indicating widening health inequalities. BAPC projections estimated that ASPR will rise to 623.351 per 100,000 and the age-standardized YLDs rate to 60.596 per 100,000 by 2038.

Conclusions Heart failure burden in Asia increased from 1990 to 2023 with marked regional and gender disparities, expanding health inequalities and is projected to continue rising through 2038.

The authors have declared no competing interest.

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GBD 2023