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. 2025 Jul;4(7):101904.
doi: 10.1016/j.jacadv.2025.101904. Epub 2025 Jun 19.

Global Trends in Ischemic Heart Disease-Related Mortality From 2000 to 2019

Vikash Jaiswal  1 , Jef Van den Eynde  2 , Yusra Mashkoor  3 , Helen Huang  4 , Vamsi Garimella  5 , Sulochana Khadka  6 , Tushar Kumar  7 , Akash Jaiswal  8 , Wilbert Aronow  9 , Maciej Banach  10 , Gregg C Fonarow  11
Affiliations

Global Trends in Ischemic Heart Disease-Related Mortality From 2000 to 2019

Vikash Jaiswal et al. JACC Adv. 2025 Jul.

Abstract

Background: Ischemic heart disease (IHD) remains one of the leading causes of morbidity and mortality across the globe, and disparities exist based on sex and geographic region.

Objectives: This study investigates global trends in IHD mortality and examines disparities based on sex and geographic regions.

Methods: IHD mortality data from 105 countries were obtained from the World Health Organization Mortality Database. Crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) per 100,000 individuals were calculated, with average annual percentage change (AAPC) analyzed using joinpoint regression. Regional and sex-specific trends were assessed using stratified analyses of CMR and ASMR.

Results: Globally, CMR declined from 138 per 100,000 (95% CI: 131-145) in 2000 to 106 per 100,000 (95% CI: 102-114) in 2019 (AAPC: -1.79, 95% CI: -1.93 to -1.66). Similarly, ASMR declined from 104 per 100,000 (95% CI: 99-108) to 65.5 (95% CI: 62-69) in 2019 per 100,000 (AAPC: -2.16, 95% CI: -2.13 to -2.20). Regionally, CMRs decreased in Oceania, Europe, and North America, while they rose in Asia, Africa, and Central and South America. ASMRs declined worldwide except in Africa (AAPC: 1.33, 95% CI: 1.30-1.36). Males showed higher mortality than females, but both sexes demonstrated decreasing trends, with males having a steeper decline. In age groups across all regions, Africa showed an upward trend, while other regions demonstrated declines.

Conclusions: While global IHD mortality has declined from 2000 to 2019, disparities by geographic region and sex persist. Implementing targeted health awareness programs and collaborative global health efforts are crucial for addressing these inequalities.

Keywords: cardiovascular pathology; global trends; ischemic heart disease; mortality.

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Conflict of interest statement

Funding support and author disclosures Dr Fonarow has consulted for Abbott, Amgen, AstraZeneca, Bayer, Boehinger Ingelheim, Cytokinetics, Eli Lilly, Johnson & Johnson, Medtronic, Merck, Novartis, and Pfizer. Dr Banach has received research grant(s)/support from Amgen, Daiichi Sankyo, Mylan/Viatris, and Sanofi and has served as a speaker and consultant for Adamed, Amgen, Daiichi Sankyo, Esperion, Exceed Pharma, Kogen, KRKA, Menarini, Mylan, Novartis, Novo Nordisk, Pfizer, Polpharma, Sanofi-Aventis, Servier, Teva, and Zentiva. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Mortality Trends for Ischemic Heart Disease per 100,000 (2000-2019), Stratified by Region (A) Annual trends in CMR and ASMR for IHD per 100,000 (2000-2019), stratified by region. (B) IHD mortality rates per 100,000 in 2019 and average annual percent change (2000-2019), stratified by region. ASMR = age-standardized mortality rate; CMR = crude mortality rate; IHD = ischemic heart disease.
Figure 2
Figure 2
Mortality Trends for Ischemic Heart Disease per 100,000 (2000-2019), Stratified by Sex (A) Annual trends in CMR and ASMR for IHD per 100,000 (2000-2019), stratified by sex. (B) IHD mortality rates per 100,000 in 2019 and AAPC (2000-2019), stratified by sex. AAPC = average annual percentage change; ASMR = age-standardized mortality rate; CMR = crude mortality rate; IHD = ischemic heart disease.
Figure 3
Figure 3
Regional Trends in Age-Specific Crude Mortality Rate per 100,000 for Ischemic Heart Disease (2000-2019)
Central Illustration
Central Illustration
Global Trends in Ischemic Heart Disease-Related Mortality From 2000 to 2019 Abbreviations as in Figure 2.
See this image and copyright information in PMC

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