The national and subnational trend of ischemic heart disease in Iran from 1990-2021, with projections for 2040: a modelling study

Background Ischemic heart disease (IHD) is a leading cause of death in Iran, and monitoring its trends is essential for disease management and achieving Sustainable Development Goal 3.4. Methods This study examines the prevalence of IHD in Iran at national and subnational levels and projects future trends to 2040. We retrieved sex-specific IHD data for Iran and its provinces from 1990 to 2021 from the Global Burden of Disease (GBD) Study 2021 and applied the illness-death model (IDM) to estimate age-standardized prevalence rates (ASPRs) by 2040. Results In Iran, the ASPR of IHD decreased until 2009 but began to rise again by 2021. By 2040, prevalence is projected to increase by 16% to 7,336.1 per 100,000 (95% CI: 7,163.9-7,512.4). In 2021, the highest provincial ASPRs were observed in Khuzestan, Yazd, and Alborz; by 2040, Yazd, Khuzestan, and North Khorasan are expected to have the highest rates. Conversely, Hamadan, Sistan and Baluchistan, and West Azarbayejan had the lowest ASPRs in both 2021 and 2040. A similar pattern was observed in both males and females. Conclusion These findings indicate an upward trend in IHD nationwide and across all provinces by 2040. To lessen the future impact of IHD in Iran, it is crucial to tackle modifiable risk factors, strengthen the healthcare system, and improve prevention efforts.