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. 2022 Jan 5;8(1):50-60.
doi: 10.1093/ehjqcco/qcaa076.

Global, regional, and national burden of ischaemic heart disease and its attributable risk factors, 1990-2017: results from the Global Burden of Disease Study 2017

Haijiang Dai  1   2 , Arsalan Abu Much  3   4 , Elad Maor  3   4 , Elad Asher  3   4 , Arwa Younis  5 , Yawen Xu  1 , Yao Lu  2 , Xinyao Liu  2 , Jingxian Shu  6 , Nicola Luigi Bragazzi  1
Affiliations

Global, regional, and national burden of ischaemic heart disease and its attributable risk factors, 1990-2017: results from the Global Burden of Disease Study 2017

Haijiang Dai et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Aims: The aim of this study was to estimate the burden and risk factors for ischaemic heart disease (IHD) in 195 countries and territories from 1990 to 2017.

Methods and results: Data from the Global Burden of Disease Study 2017 were used. Prevalence, incidence, deaths, years lived with disability (YLDs), and years of life lost (YLLs) were metrics used to measure IHD burden. Population attributable fraction was used to estimate the proportion of IHD deaths attributable to potentially modifiable risk factors. Globally, in 2017, 126.5 million [95% uncertainty interval (UI) 118.6 to 134.7] people lived with IHD and 10.6 million (95% UI 9.6 to 11.8) new IHD cases occurred, resulting in 8.9 million (95% UI 8.8 to 9.1) deaths, 5.3 million (95% UI 3.7 to 7.2) YLDs, and 165.0 million (95% UI 162.2 to 168.6) YLLs. Between 1990 and 2017, despite the decrease in age-standardized rates, the global numbers of these burden metrics of IHD have significantly increased. The burden of IHD in 2017 and its temporal trends from 1990 to 2017 varied widely by geographic location. Among all potentially modifiable risk factors, age-standardized IHD deaths worldwide were primarily attributable to dietary risks, high systolic blood pressure, high LDL cholesterol, high fasting plasma glucose, tobacco use, and high body mass index in 2017.

Conclusion: Our results suggested that IHD remains a major public health challenge worldwide. More effective and targeted strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors are urgently needed, particularly in geographies with high or increasing burden.

Keywords: Epidemiology; Global heath; Ischaemic heart disease; Risk factor.

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Figures

Figure 1
Figure 1
Age-specific numbers and rates of prevalent cases (A), incident cases (B), and deaths (C) of ischaemic heart disease by sex, 2017. Error bars indicate the 95% uncertainty interval (UI) for numbers. Shading indicates the 95% UI for rates.
Figure 2
Figure 2
Age-standardized incidence (A) and death (B) rates of ischaemic heart disease across 195 countries and territories for both sexes, 2017. ATG, Antigua and Barbuda; FSM, Federated States of Micronesia; Isl, Islands; LCA, Saint Lucia; TLS, Timor-Leste; TTO, Trinidad and Tobago; VCT, Saint Vincent and the Grenadines.
Figure 3
Figure 3
Trend in age-standardized incidence (A) and death (B) rates of ischaemic heart disease globally and for 21 GBD regions by socio-demographic index, 1990–2017. For each region, points from left to right depict estimates from each year from 1990 to 2017. GBD, Global Burden of Disease, Injuries, and Risk Factors Study.
Figure 4
Figure 4
Percentage contributions of major risk factors to ischaemic heart disease age-standardized deaths by sex, 2017. The cumulative impact of risk factors is not the simple addition of their individual contributions as the risk factors may overlap. Mediation adjustment is needed when aggregating the population attributable fractions across multiple risk factors.
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