Global burden and national health inequity of ischemic heart disease attributed to kidney dysfunction from 1990 to 2021: Findings from the global burden of disease study 2021

Abstract

Background and aims: To estimate the global disease burden and cross-national inequalities in the distribution of ischemic heart disease attributable to kidney dysfunction (KI-IHD) from 1990 to 2021.

Methods: The estimates for age-standardized death rates (ASDR) and age-standardized disability-adjusted life-years rates (ASDAR) of KI-IHD were obtained from the Global Burden of Disease Study (GBD) 2021. Data for gross domestic product (GDP) and GDP growth rates were extracted from World Bank database. The average annual percent change (AAPC) was calculated to analyze temporal trends of ASDR and ASDAR by Joinpoint regression model. Slope index of inequality and concentration index were generated to quantify the cross-national socioeconomic inequality of KI-IHD burden.

Results: From 1990 to 2021, the ASDR and ASDAR of KI-IHD has shown downward trend globally; with AAPC values of -1.384 % and -1.204 %. The ASDR and ASDAR of KI-IHD was higher in males than females, with increasing age, the burden gradually increased. The concentration index showed 0.02 (95%CI: 0.02, 0.06) in 1990 and -0.11 (95%CI: 0.15, -0.07) in 2021. The slope index of inequality showed that an excess of 170 ASDR per 100,000 existed between countries with the lowest and the highest SDI in 1990, however, in 2021, the results are reversed, a reduction of 159 per 100,000. GDP growth rate and GDP per capita might be associated with the health inequality of KI-IHD.

Conclusion: The burden of KI-IHD has decreased in almost 70 % of countries over the past three decades. Disproportional distribution of health inequalities was concentrated in poor countries.

Keywords: Average annual percent change; Global disease burden; Health inequalities; Ischemic heart disease; Kidney dysfunction; Trend analysis.