AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Burden of Ischemic Heart Disease and Its Attributable Risk Factors from 1990 to 2021, and Forecasts Till 2050: A Comparative Analysis of Low versus High Socio-Demographic Index (SDI) Regions
By Farooq M, Safiullah M, Hayat MS et al.
Background: Ischemic heart disease (IHD), the leading cause of mortality among non-communicable diseases globally, is a group of chronic diseases characterized by coronary ischemia of the heart and subsequent myocardial damage. Objective: We aimed to evaluate the influence of gender, risk factors, and the sociodemographic index (SDI) on the burden of IHD from 1990 to 2021. Methods: Data from the Global Burden of Disease (GBD) 2021 project was used to analyze age-standardized incidence (ASIR), mortality (ASMR), and disability-adjusted life years (ASDR) rates for IHD across high and low SDI regions. Joinpoint regression was used to evaluate trends via average annual percentage changes (AAPCs) and annual percentage changes (APCs). Forecasts till 2050 were performed using the ARIMA model on STATA (Version 17.0). Results: In 2021, the burden of IHD remained markedly higher in low SDI regions compared to their high SDI counterparts. Between 1990 and 2021, high SDI regions demonstrated substantial improvements, while low SDI regions exhibited only modest progress. High SDI areas recorded a 43% reduction in ASIR (AAPC: -1.81; 95% CI: -1.85 to -1.78), a 63% decline in the ASMR (AAPC: -3.22; 95% CI: -3.26 to -3.18), and a 61% decrease in ASDR (AAPC: -3.06; 95% CI: -3.09 to -3.00). In contrast, low SDI regions showed only slight reductions: 6% reduction in ASIR (AAPC -0.23; 95% CI: -0.26 to -0.19), a 3% decrease in ASMR (AAPC -0.05; 95% CI: -0.10 to -0.01), and an 8% drop in ASDR (AAPC -0.26; 95% CI: -0.30 to -0.22). Projections suggest a gradual increase in ASMR and DALYs by 2050. From 1999 to 2021, both sexes in high SDI areas experienced significant reductions, more pronounced among females. However, improvements in low SDI regions were minimal, particularly among females. In high SDI regions, all indicators declined notably in both sexes, while in low SDI regions, ASMR and ASDR among males showed slight increases. Metabolic risk factors-particularly elevated systolic blood pressure and LDL cholesterol-were the primary contributors to IHD burden. Although all major risk factors declined over time, projections indicate a future rise in metabolic and dietary-related burden. Conclusion: Despite declining age-standardized rates, population growth and aging threaten to increase crude IHD burden. Targeted interventions addressing metabolic risks, air pollution, and regional/gender disparities are urgently needed.