Changing trends in the global burden of ischemic heart disease among individuals aged 15–39 years: decline, disparities, and a post-2020 reversal

Background Ischemic heart disease (IHD) in young populations represents an emerging global public health concern. Compared with older adults, young individuals with IHD often present with insidious onset and potentially severe long-term consequences. Updated evidence on global and regional trends in IHD burden among young people remains limited. Purpose To estimate the global, regional, and national burden of IHD among individuals aged 15–39 years from 2010 to 2023 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. Methods Data on prevalence, mortality, and disability-adjusted life years (DALYs) were extracted for individuals aged 15–39 years between 2010 and 2023. Analyses were stratified by sex, region, and socio-demographic index (SDI). Temporal trends were assessed using Joinpoint regression, calculating average annual percent changes (AAPCs) and annual percent changes (APCs). Results Globally, IHD prevalence declined from 659.08 (95% uncertainty interval [UI] 532.89–824.78) per 100,000 in 2010 to 608.74 (95% UI, 487.98–757.93) in 2023, a 7.64% reduction. The DALY rate decreased from 429.36 (95% UI, 360.37–508.29) to 418.69 (95% UI, 354.63–513.06). Prevalence remained consistently higher in males, with the male-to-female ratio increasing from 1.41 to 1.46. The global prevalence rate showed an AAPC of –0.61, declining from 2010–2020 (APC –0.92) but reversing during 2021–2023 (APC 0.57). DALY rates increased slightly from 2010–2013 (APC 1.17), declined from 2013–2020 (APC –1.86), and demonstrated a non-significant upward trend after 2020. Substantial regional heterogeneity was observed. In 2023, the highest prevalence occurred in the High-middle SDI region (819.45 [95% UI, 649.80–1037.50]), which remained stable over time (AAPC –0.04). The Middle SDI region had the highest DALY rate and showed an overall increasing trend (AAPC 0.69). Nationally, Trinidad and Tobago, Uzbekistan, and Azerbaijan had the highest prevalence rates in 2023. Among the 30 most populous countries aged 15–39 years, Egypt showed the largest decline, whereas China and Mexico exhibited the greatest increases over the past five years. Conclusion Although the global burden of IHD among individuals aged 15–39 years declined overall between 2010 and 2023, marked regional disparities persist. The recent post-2020 increase in prevalence warrants attention. Region-specific prevention strategies targeting young populations are urgently needed.