Key result
By 2040, the age-adjusted prevalence of ischemic heart disease in South Asia is projected to increase to 9,846.6 per 100,000 compared to 9,434.6 in 2021 (EAPC 0.23%; 95% CI 0.08%-0.37%).
Why the study?
Atherosclerotic cardiovascular disease disproportionately impacts low-middle income countries such as those in South Asia, and understanding future ASCVD rates can inform public policy.
Observational
Yes
The prevalence of ischemic heart disease and peripheral artery disease is projected to increase in South Asia by 2040, with a disproportionate rise among females, emphasizing the need for targeted preventive strategies.
May prompt gender-focused prevention planning in South Asia; leaves open intervention impact on projected trends.
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) disproportionately impacts low-middle income countries, such as those in South Asia and understanding future ASCVD rates can inform public policy. OBJECTIVES: This study aimed to project the burden of ASCVD in South Asia till 2040. METHODS: Yearly ischemic heart disease (IHD), stroke, and peripheral artery disease (PAD) counts for South Asia (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) and mid-year population were obtained from Global Burden of Disease (1990-2021) in 5-year age brackets (40-79 years) and estimated mid-year national population (2022-2040) was collected. Age-adjusted prevalence (aaPR) and mortality rate (per 100,000) were projected with Bayesian age-period-cohort models in South Asia (overall, males, and females); trends were reported as the estimated annual percent change (EAPC). RESULTS: Between 2021 and 2040, the IHD aaPR in South Asia was projected to increase (2021: 9434.6 [95% CI: 9,432.1-9,437.1], 2040: 9,846.6 [95% CI: 8,800.0-10,893.3], EAPC: 0.23% [95% CI: 0.08%-0.37%]) because of increased rates among females (EAPC: 1.16%; 95% CI: 1%-1.32%). The overall IHD age-adjusted mortality rate will reduce (2021: 254.7 [95% CI: 254.3-255.1), 2040: 224.0 [95% CI: 166.5-281.6), EAPC: -0.67% [95% CI: -1.61% to 0.27%]) but may increase in females (EAPC: 1.16%; 95% CI: 1%-1.32%). Stoke aaPR in South Asia is projected to increase slightly (2021: 1,065.5 [95% CI: 1,064.7-1,066.4], 2040: 1,074.6 [95% CI: 953.7-1,195.5]). The PAD aaPR is projected to increase (2021: 1809.5 [95% CI: 1,808.5-1,810.6], 2040: 1,879.5 [95% CI: 1,684.9-2,074.0], EAPC: 0.26% [95% CI: 0.04%-0.47%]) because of increased rates in females (EAPC: 0.29%; 95% CI: -0.01% to 0.59%). CONCLUSIONS: IHD and PAD prevalence rates are projected to increase in South Asia with a disproportionate increase among females.
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Cotton et al. (2025) conducted an observational in Atherosclerotic cardiovascular disease (ASCVD). Future projection (Year 2040) vs. Year 2021 was evaluated on Ischemic heart disease age-adjusted prevalence rate (per 100,000) (EAPC 0.23%, 95% CI 0.08%-0.37%). By 2040, the age-adjusted prevalence of ischemic heart disease in South Asia is projected to increase to 9,846.6 per 100,000 compared to 9,434.6 in 2021 (EAPC 0.23%; 95% CI 0.08%-0.37%).
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