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

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:We utilized data from the Global Burden of Disease 2021 study to assess CHD prevalence,incidence,and mortality rates.Trends were analyzed using Joinpoint regression,age-period-cohort models and autoregressive integrated moving average(ARIMA)forecasting.Health inequality was quantified using the slope index of inequality(SII)and the concentration index(CI),and associations with the Socio-Demographic Index(SDI)were explored.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.