Epidemiological characteristics, risk factors, and prevention and control progress of ischemic heart disease in elderly people in China

The aging population in China continues to intensify, and ischemic heart disease (IHD) has become the leading cause of death and disability among the elderly population (> 60 years), with a substantial disease burden. This review is based on multiple databases and summarizes the epidemiological characteristics, multidimensional risk factors, pathogenesis, diagnosis and treatment techniques, as well as prevention and control progress of elderly IHD in China. Although the standardized incidence and mortality indicators of IHD among the elderly in China have slightly declined, driven by population aging, the absolute total number of cases, deaths, and Disability-Adjusted Life-Years (DALYs) continues to rise. The disease burden shows a distribution pattern of high in the north and low in the south, higher in rural areas than in cities, concentrated in the population over 70 years old, and accelerated risk growth among elderly women; Non-modifiable factors (age, gender, heredity), unhealthy lifestyle, hypertension/diabetes and other comorbidity, psychosocial factors, and environmental pollution constitute a superposition risk. Aging related coronary microvascular disease, mitochondrial dysfunction, chronic low-grade inflammation, and imbalance of multiple signaling pathways are the core pathological mechanisms of elderly ischemic myocardial injury. Non invasive cardiac imaging, high-sensitivity troponin, and multiple-omics biomarkers may be can improve diagnostic accuracy in elderly patients with atypical symptoms. A hierarchical chronic disease prevention and control system has been established in China, but weak community-level monitoring, insufficient disease awareness among the population, and the slow translation of research findings into clinical practice remain weaknesses. In the future, it is necessary to rely on local cohorts to deepen research on the etiology and mechanism of aging, promote comprehensive multidimensional risk-factor intervention, and provide scientific basis for reducing the burden of cardiovascular disease in the elderly and achieving healthy aging.