Abstract

Background: Chronic kidney disease (CKD) attributable to hypertension represents a major global public health challenge. This study evaluates the global burden of CKD statistically attributable to high systolic blood pressure (SBP), with a focus on young adults aged 25–49 years.

Aims: To analyze trends in mortality and disability-adjusted life years (DALYs) attributable to high SBP among individuals with CKD aged 25–49 years from 1990 to 2021 and to project the future attributable burden through 2050.

Study Design: Observational study.

Methods: Data were obtained from the Global Burden of Disease Study 2021. The analysis estimated the burden of CKD attributable to high SBP using a comparative risk assessment framework. Temporal trends were quantified using the estimated annual percentage change (EAPC). The association between attributable burden and the sociodemographic index (SDI) was also examined. Projections to 2050 were generated using autoregressive integrated moving average models.

Results: From 1990 to 2021, global mortality and DALY rates for CKD attributable to high SBP among young adults increased significantly (mortality EAPC, 1.75%; DALYs EAPC, 1.6%). The attributable burden remained consistently higher in males and increased with age, peaking in the 45–49-year age group. Overall, low- and low-middle-SDI regions experienced the greatest relative increases, although substantial heterogeneity was observed within SDI strata. At the national level, Ukraine showed the largest increase in mortality rate (EAPC, 13.21%), whereas the Republic of Korea exhibited the largest decline (EAPC, −4.68%). Model-based projections suggest a continued increase in both attributable mortality and DALYs through 2050, with persistent disparities by sex, age, and geographic region.

Conclusion: The burden of CKD attributable to high SBP among young adults has increased substantially over the past three decades and is projected to rise further, reflecting persistent global inequalities. These findings highlight the urgent need for strengthened and targeted strategies for hypertension prevention and management in younger populations worldwide.