Trends in Ischemic Heart Disease Burden in China From 1992 to 2021: Prevalence, Mortality Rates, and Attributable Risks From Four Key Factors

Background Ischemic heart disease (IHD), the leading cause of global mortality, poses a significant public health challenge, especially in China. This study aimed to analyze the temporal trends in IHD burden and investigate mortality patterns linked to four key risk factors in China from 1992 to 2021, providing evidence to inform preventive strategies. Methods Based on the publicly available GBD 2021 data, we used join‐point regression to estimate annual percentage changes (APCs) in IHD prevalence and mortality rates. The age–period–cohort (APC) model was employed to assess the effects of age, period, and cohort, while the Bayesian age–period–cohort (BAPC) model was used to project trends for the next 11 years (2022–2032). Results The age‐standardized IHD prevalence increased from 2548.87 to 3042.35 per 100,000 and the mortality rate from 93.24 to 110.91 per 100,000 with a consistent male predominance. The four leading risks remained unchanged between 2012 and 2021: high systolic blood pressure, high LDL cholesterol, ambient particulate matter pollution, and smoking. Prevalence increased exponentially after age 40 and mortality after age 60. The period effect indicated a continuous increase in IHD risk, but mortality risk generally declined after 2006. Later birth cohorts exhibited elevated prevalence risks but reduced mortality probabilities. Projections indicated that female prevalence would increase over the next 11 years. Conclusions The escalation of China’s IHD burden over 3 decades remains a critical public health challenge. Targeted strategies focusing on key risk factors are essential to reduce the IHD burden, especially among males and older adults.