Global burden of ischemic heart disease from 1990 to 2021: Findings from the Global Burden of Disease Study 2021 and predictions to 2030

Abstract

Background: – Ischemic heart disease (IHD) remains the leading cause of global morbidity and mortality, yet comprehensive analyses of its burden across sociodemographic contexts and future projections are limited. This study leverages the Global Burden of Disease (GBD) 2021 database to assess the global, regional, and national burden of IHD from 1990 to 2021 and predicts trends up to 2030. Methods: – Data on IHD prevalence, incidence, disability-adjusted life years (DALYs), and mortality were extracted from the GBD 2021 database. Age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs) were calculated to evaluate temporal trends. The Bayesian Age-Period-Cohort (BAPC) model was employed to project age-standardized incidence rates (ASIRs) through 2030. Analyses were stratified by sociodemographic index (SDI), age, sex, and region. Results: – From 1990 to 2021, global IHD cases increased by 127%, reaching 254.28 million, with the sharpest rises in East Asia and Andean Latin America. Age-standardized incidence, DALYs, and mortality rates declined globally (EAPC: −44%, −120%, and −130%). High-SDI regions exhibited significant reductions in mortality (EAPC: −130%), while low-, low-to-middle-, and middle-SDI regions faced rising burdens in some indications. Men had consistently higher rates than women, particularly in the elderly population. Projections suggest continued declines in ASIRs through 2030, driven largely by reductions among adults aged ≥70 years, while incidence among younger adults (30–49 years) is expected to fluctuate. Conclusions: – From 1990 to 2021, the global absolute number of IHD cases increased, yet ASRs for prevalence, incidence, DALYs, and mortality declined across all age groups and genders, with greater reductions observed in higher SDI regions. Projections indicate a continued decrease in ASIR through 2030, with the most significant reductions expected in the ≥70 years age group. These findings highlight the critical need for enhanced prevention and healthcare policies to address the global IHD burden effectively. In low- and middle-SDI regions, policy efforts should be intensified to control risk factors, whereas in high-SDI regions the focus should be on secondary prevention and rehabilitation.