What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic Heart Disease. Intervention: Central Asian region vs. Global population. Primary outcome: Percentage change in age-standardized death rate (ASDR) for IHD from 1990 to 2017 (95% CI 11.9-21.9).

What does this research mean for the field?

The age-standardized death rate for ischemic heart disease increased by 16.7% in Central Asia from 1990 to 2017, contrasting with a 30% decrease globally, with unhealthy diet, high systolic blood pressure, and high LDL-cholesterol as the highest attributable risk factors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 7, 2021Open Access

Burden of Ischemic Heart Disease in Central Asian Countries, 1990–2017

Key Result

The age-standardized death rate for ischemic heart disease increased by 16.7% in Central Asia from 1990 to 2017, contrasting with a 30% decrease globally.

Study Design

Type

Observational

Structured PICO

Population

Populations of Central Asian countries (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan)

Outcome

Age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of ischemic heart disease by sexhard clinical

Central Asia has a disproportionately high burden of ischemic heart disease, driven largely by unhealthy diet, high systolic blood pressure, and high LDL-cholesterol.

Main Result

Absolute Event Rate: 16.7% vs -30%

Limitations

Gaps, biases, and inconsistencies in data sources
Limitations in the methods of data processing and estimation
Differences in data and estimation methodology limiting comparisons with other studies
Potential under-reporting or miscoding of IHD

Abstract

BACKGROUND: The burden of ischemic heart disease (IHD) is high. There is limited information on the burden of IHD in identified high risk areas like Central Asia (CA) which is comprised of Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan. This study addresses the burden of IHD in CA at the regional and country levels. METHODS: Using data from the latest iteration of the Global Burden of Disease Study (GBD), this study provides age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of IHD by sex in the CA region, and national levels for countries in this region from 1990 to 2017. RESULTS: The CA region has a higher IHD burden than the rest of the world over the studied period. Amongst the countries within this region, age-standardized mortality and DALY rates in Uzbekistan are the highest not only in CA but worldwide, while Armenia consistently has the lowest IHD burden in CA. Unhealthy diet, high systolic blood pressure and LDL-cholesterol are the risk factors with the highest attributable IHD DALYs. CONCLUSION: There is considerable variation in IHD DALY rates among countries in the CA region. The reasons for such differences are likely multifactorial such as differences in risk factors distribution, health care effectiveness, political, social and economic factors.

Bookmark

View Full Paper