Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021

Abstract Background Ischemic heart disease (IHD) continues to be the foremost contributor to global morbidity and mortality. This analysis aims to report an updated assessment of prevalence, deaths, and disability-adjusted life years (DALYs) due to IHD and its attributable risk factors in 204 countr...

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Main Authors: Leyuan Yang, Bo Zheng, Yanjun Gong
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-05022-x
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author Leyuan Yang
Bo Zheng
Yanjun Gong
author_facet Leyuan Yang
Bo Zheng
Yanjun Gong
author_sort Leyuan Yang
collection DOAJ
description Abstract Background Ischemic heart disease (IHD) continues to be the foremost contributor to global morbidity and mortality. This analysis aims to report an updated assessment of prevalence, deaths, and disability-adjusted life years (DALYs) due to IHD and its attributable risk factors in 204 countries and territories from 1990 to 2021, by age, sex, and socio-demographic index (SDI). Methods This analysis used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. IHD was defined as acute myocardial infarction, chronic stable angina, chronic IHD, and heart failure due to IHD. Major indicators used in this study were prevalence, death and DALYs. All estimates were reported as absolute counts and age-standardized rates per 100,000 population, along with their 95% uncertainty intervals (UIs). Results Globally, IHD accounted for 254.3 (95%UI: 221.4 to 295.5) million prevalent cases, 9.0 (95%UI: 8.3 to 9.5) million deaths and 188.4 (95%UI: 177.0 to 198.1) million DALYs in 2021. There was a noticeable decline in the global age-standardized death rate (ASDR) [-31.6% (95%UI: -34.9 to -28.3)] and age-standardized DALYs (ASRDALYs) [-28.8% (95%UI: -32.5 to -25.2)] from 1990 to 2021, with an estimated annual percentage change of -1.3 (95%CI: -1.34 to -1.26) and − 1.2 (95%CI: -1.25 to -1.16), respectively. In 2021, the global prevalence, death, and DALY rates of IHD were higher among males across all age groups, while death and DALY rates reaching a peak in the oldest group for both sexes. Regionally, we found a nonlinear but negative association between age-standardized prevalence rate (ASPR) and SDI. Nationally, similar negative associations were observed between ASRDALYs and SDI. High systolic blood pressure and high low-density lipoprotein cholesterol were the factors contributing most to the deaths and DALYs due to IHD. Conclusions Despite declining global age-standardized death and DALYs rates of IHD, sustained multilevel prevention strategies remain essential. This requires population-wide risk factor reduction, targeted interventions for high-risk populations, and strengthened community healthcare networks to ensure accessible, guideline-based management.
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spelling doaj-art-42e99bd6cd674ee99ae5662dc41049fe2025-08-24T11:06:48ZengBMCBMC Cardiovascular Disorders1471-22612025-08-0125111510.1186/s12872-025-05022-xGlobal, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021Leyuan Yang0Bo Zheng1Yanjun Gong2Department of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalAbstract Background Ischemic heart disease (IHD) continues to be the foremost contributor to global morbidity and mortality. This analysis aims to report an updated assessment of prevalence, deaths, and disability-adjusted life years (DALYs) due to IHD and its attributable risk factors in 204 countries and territories from 1990 to 2021, by age, sex, and socio-demographic index (SDI). Methods This analysis used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. IHD was defined as acute myocardial infarction, chronic stable angina, chronic IHD, and heart failure due to IHD. Major indicators used in this study were prevalence, death and DALYs. All estimates were reported as absolute counts and age-standardized rates per 100,000 population, along with their 95% uncertainty intervals (UIs). Results Globally, IHD accounted for 254.3 (95%UI: 221.4 to 295.5) million prevalent cases, 9.0 (95%UI: 8.3 to 9.5) million deaths and 188.4 (95%UI: 177.0 to 198.1) million DALYs in 2021. There was a noticeable decline in the global age-standardized death rate (ASDR) [-31.6% (95%UI: -34.9 to -28.3)] and age-standardized DALYs (ASRDALYs) [-28.8% (95%UI: -32.5 to -25.2)] from 1990 to 2021, with an estimated annual percentage change of -1.3 (95%CI: -1.34 to -1.26) and − 1.2 (95%CI: -1.25 to -1.16), respectively. In 2021, the global prevalence, death, and DALY rates of IHD were higher among males across all age groups, while death and DALY rates reaching a peak in the oldest group for both sexes. Regionally, we found a nonlinear but negative association between age-standardized prevalence rate (ASPR) and SDI. Nationally, similar negative associations were observed between ASRDALYs and SDI. High systolic blood pressure and high low-density lipoprotein cholesterol were the factors contributing most to the deaths and DALYs due to IHD. Conclusions Despite declining global age-standardized death and DALYs rates of IHD, sustained multilevel prevention strategies remain essential. This requires population-wide risk factor reduction, targeted interventions for high-risk populations, and strengthened community healthcare networks to ensure accessible, guideline-based management.https://doi.org/10.1186/s12872-025-05022-xIschemic heart diseaseGBD 2021EpidemiologyRisk factors
spellingShingle Leyuan Yang
Bo Zheng
Yanjun Gong
Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
BMC Cardiovascular Disorders
Ischemic heart disease
GBD 2021
Epidemiology
Risk factors
title Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
title_full Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
title_fullStr Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
title_full_unstemmed Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
title_short Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021
title_sort global regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021 a systematic analysis of the global burden of disease study 2021
topic Ischemic heart disease
GBD 2021
Epidemiology
Risk factors
url https://doi.org/10.1186/s12872-025-05022-x
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AT yanjungong globalregionalandnationalburdenofischemicheartdiseaseanditsattributableriskfactorsfrom1990to2021asystematicanalysisoftheglobalburdenofdiseasestudy2021