Hypertension-Related CKD Burden Rises Globally, Driven by Aging and Metabolic Risk

The global burden of chronic kidney disease attributable to hypertension (HT-CKD) has increased substantially over the past 3 decades, driven largely by aging populations and modifiable metabolic risk factors, according to a new analysis published in Frontiers in Nutrition.

Using data from the Global Burden of Disease (GBD) Study, investigators assessed trends in HT-CKD prevalence, mortality, and disability-adjusted life years (DALYs) across age groups, sex, geographic regions, and sociodemographic index (SDI) categories. The findings suggest that despite improvements in some regions, HT-CKD remains an escalating public health concern worldwide.

Rising Mortality and Disability Burden

Globally, HT-CKD mortality and DALYs increased steadily between 1990 and 2021, with the sharpest rises observed in older adults. Mortality rates increased markedly with advancing age, particularly among individuals aged 80 years and older, according to age-stratified analyses.

High-SDI regions experienced the steepest increases in age-standardized mortality rates, while low- and low-middle SDI regions demonstrated the greatest growth in DALYs. Investigators noted that these trends reflect differences in population aging, metabolic risk exposure, and access to preventive care.

Sex- and Region-Specific Differences

Men consistently exhibited higher mortality and DALY rates related to HT-CKD compared with women across most regions. However, the study identified important sex-specific considerations, including the need for postmenopausal renal protection strategies among women.

Regionally, East Asia and parts of South Asia contributed disproportionately to the global burden, while high-income regions showed rising rates linked to obesity, hypertension, and metabolic syndrome in older adults.

Implications for Primary Care and Prevention

The authors emphasized that hypertension-related CKD is largely driven by modifiable risk factors, including obesity, physical inactivity, and poor blood pressure control. They called for national strategies that integrate fiscal policy, environmental interventions, and strengthened primary health care systems to improve early screening and management.

The study also highlighted the importance of tailoring interventions to regional and demographic needs, including targeted metabolic risk reduction in aging populations in high-SDI regions and improved basic health care capacity in lower-SDI settings.

Study Context and Limitations

This analysis relied on publicly available GBD data rather than individual-level clinical data, which limits the ability to assess patient-specific risk factors or treatment patterns. However, the authors noted that the large, standardized dataset enables robust global comparisons over time.

Conclusion

The findings underscore hypertension-related chronic kidney disease as a growing global challenge closely linked to aging and metabolic risk. According to the authors, coordinated prevention strategies focused on blood pressure control, obesity management, and early CKD detection will be essential to curb future disease burden.