Global Burden and Trends of Ischemic Heart Disease in Women Aged 55 years and Older, 1990–2021: A Systematic Analysis of the Global Burden of Disease Study 2021

Purpose: To characterize the global burden and long-term trends of ischemic heart disease (IHD) among women aged ≥55 years, with particular attention to regional, socioeconomic and age-specific variation. Patients and methods: From the Global Burden of Disease Study 2021 we extracted disability-adjusted life-year (DALY), death and incidence counts and age-standardized rates (ASRs) for IHD in women aged ≥55 years across 204 countries, 21 regions and five Socio-demographic Index (SDI) strata. Estimated annual percentage changes (EAPCs) were derived by log-linear regression of ln (ASR) on calendar year. Trends were examined by region, by SDI and across nine five-year age bands from 55-59 to ≥95 years. Results: Globally, DALYs rose from 40.0 to 60.6 million (EAPC 1.23), deaths from 2.36 to 3.71 million (EAPC 1.39) and incident cases from 5.69 to 11.69 million (EAPC 2.20), while ASRs fell (DALY EAPC -1.53; death EAPC -1.60; incidence EAPC -0.57). Burden was highest in Central Asia (19,862.64/100 000), Eastern Europe (17,690.80) and North Africa and the Middle East (16,239.37), and lowest in the high-income Asia Pacific (1359.50), Australasia (2469.28) and Western Europe (2590.61). Western Europe (-4.46), Australasia (-5.27) and the high-income Asia Pacific (-3.83) declined fastest; East Asia (0.23), South Asia (0.00) and southern sub-Saharan Africa (0.65) rose or stayed flat. Incidence in women aged ≥95 years grew fastest (EAPC 4.49). Conclusion: Older women bear a growing absolute IHD burden whose age-standardized intensity is falling unevenly worldwide. These findings highlight the need for clinicians to recognize the increasing IHD burden in older women and for public health systems to incorporate age- and sex-specific burden patterns into preventive care and health-resource planning.