Three decades of global ischemic heart disease burden

Figure 1.. Geographic distribution and temporal trends of IHD incidence from 1990 to 2021. ASIR of IHD in (A) 1990, (B) 2021; (C) relative change (%) in ASIR between 1990 and 2021; (D) EAPC in ASIR from 1990 to 2021. Data are presented for 204 countries and territories based on GBD study 2021. ASIR = age-standardized incidence rate, EAPC = estimated annual percentage change, GBD = Global Burden of Disease, IHD = ischemic heart disease.

Figure 2.. Temporal trends in age-standardized prevalence, incidence, death, and DALY rates of IHD by SDI quintiles globally, 1990 to 2021. (A) Age-standardized prevalence, (B) incidence, (C) deaths, (D) and DALYs per 100,000 population are shown across global SDI quintiles. Solid lines represent point estimates; shaded areas denote 95% UIs. DALY = disability-adjusted life-years, IHD = ischemic heart disease, SDI = sociodemographic index, UI = uncertainty interval.

Figure 3.. (A) Age- and sex-specific incidence, (B) prevalence, (C) deaths, (D) and DALYs of IHD globally in 2021. Bars represent absolute numbers, and lines represent age-specific rates per 100,000 population, stratified by sex and 5-year age groups. Error bars and shaded areas indicate 95% UIs. DALY = disability-adjusted life-years, IHD = ischemic heart disease, UI = uncertainty interval.

Figure 4.. Proportion of IHD DALYs attributable to level 2 modifiable risk factors across global SDI strata in 2021.The stacked bar chart shows the percentage contributions of the top risk factors to IHD DALYs across 6 SDI strata. DALY = disability-adjusted life-years, IHD = ischemic heart disease, LDL = low-density cholesterol, SDI = sociodemographic index.

Figure 5.. Temporal trends in the global burden of IHD from 1990 to 2021. (A) ASIR, (B) ASDR, and (C) age-standardized DALYs rate, each presented with AAPC. All rates are per 100,000 population. AAPC = average annual percentage change, ASDR = age-standardized death rate, ASIR = age-standardized incidence rate, DALY = disability-adjusted life-years, IHD = ischemic heart disease.

Figure 6.. Net drift, local drifts, and age–period–cohort effects on IHD DALY rates, 1992 to 2021. (A) Net drift and local drift by age group (% per year); (B) Age effects (DALY rates per 100,000 person-years); (C) Period effects (rate ratios); (D) Cohort effects (rate ratios). DALY = disability-adjusted life-years, IHD = ischemic heart disease.

Figure 7.. BAPC projections of IHD incidence and mortality from 2022 to 2035. The 4-panel chart presents BAPC-based projections of global incidence and mortality for IHD. (A) and (B) Projected crude numbers of global IHD incidence and deaths, respectively; (C) and (D) Corresponding age-standardized rates. Shaded areas indicate 95% UIs derived from the BAPC model. The forecasts suggest a continued increase in absolute case and death counts (A, B), alongside gradual declines in age-standardized incidence and mortality rates (C, D) through 2035. BAPC = Bayesian age–period–cohort, IHD = ischemic heart disease, UI = uncertainty interval.

Figure 8.. Frontier analysis of IHD DALY rates by SDI, 2021. The curve represents the lowest observed burden across SDI levels. Countries above the curve exhibit unrealized potential for improvement, while those near the frontier demonstrate higher efficiency in burden control. Each point represents a country or territory, and only selected representative countries are labeled for visual clarity. DALY = disability-adjusted life-years, IHD = ischemic heart disease, SDI = sociodemographic index.