Three-decade analysis of regional disparities in metabolic risk factor related ischemic heart disease mortality: Contrasting trends between South Asia and North America

Background: The impact of metabolic risk factors on ischemic heart disease (IHD) exhibits substantial regional variability. This study aims to analyze three-decade mortality trends in two contrasting regions of North America (NA) and South Asia (SA), focusing on age- and gender-specific variations. Methods: Data from the Global Burden of Disease (GBD) database 1990-2021 were employed in Joinpoint Regression Program to compute the Annual Percent Changes (APC) and Average Annual Percent Changes (AAPC). Mortality rate trends were disaggregated by age and gender and subsequently compared both within and between the NA and SA populations, with statistical significance set at P < 0.05. Results were graphically represented, with mortality rates per 100,000 on the y-axis and years on the x-axis. Results: An overall decline in mortality rates was noted in NA, whereas SA displayed an overall increase. Age-specific stratification revealed that older adults in NA had a higher baseline mortality rate and experienced a more pronounced decline compared to younger adults. In contrast, older adults in SA exhibited a significant increase in mortality rates, whereas younger adults showed no significant change. Gender-specific analysis indicated substantial reductions in mortality rates for both males and females in NA, while SA males demonstrated a sharper increase, and SA females experienced no significant change. Conclusions: Our study revealed divergent trends in metabolic risk factor-related IHD mortality between NA and SA, with significant variations observed across age and gender groups emphasizing the necessity of investigating the socioeconomic, environmental, and genetic determinants driving these disparities.