Ischemic Heart Disease Burden and Attributable Risk Factors in 195 Countries and Territories, 1990-2017: Results from the Global Burden of Disease Study 2017

Abstract

Background: Ischemic heart disease (IHD) is the leading cause of death worldwide. We aimed to estimate IHD incidence, mortality, and disability-adjusted life years (DALYs) by country, sex, age group, and social-demographic status for 21 world regions for the years from 1990 to 2017. Methods: In current study of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2017, we extracted data for incidence, deaths of cases, disability-adjusted life-years (DALYs), and age-standardized rates as measures of ischemic heart disease burden using the GBD Results Tool. Trend analyzes of incidence, mortality, and DALYs were conducted for major regions. Risk factors for DALYs from the GBD comparative risk assessment framework were also evaluated and analyzed. Findings: Globally, 10,636,538 cases of IHD occurred overall in 2017, with 8,930,369 deaths. IHD mortality was highest in the low-middle SDI quantile. From 1990 to 2017, both IHD ASIR and ASDR declined globally, especially in high SDI countries. IHD related DALYs were 170,275,348 globally in 2017, for which the middle SDI quintile contributed the most. According to the results of regional analysis of SDI over time, incidence, mortality, and DALYs in most regions declined steadily as SDI increased during the same period. Among the risk factors associated with DALY, high systolic blood pressure (SBP) was the most significant contributor in most GBD regions. In contrast, other risk factors included high LDL cholesterol, diet low in nuts and seeds, high fasting plasma glucose (FPG), diet low in whole grains, and smoking. Interpretation: Even though the trend of IHD morbidity and mortality were decreasing globally, it is still at a high level, leading to a considerable burden of disease. Particularly in lower SDI countries, the rate of decline is limited in many ways and the performance is much worse than that in higher SDI countries. Therefore, sustained global and regional IHD epidemiology estimates are needed for estimating the worldwide burden of IHD. Finally, yet importantly, effective measures should be taken to address the attributable risk factors to reduce the burden of IHD. Funding Statement: This research was funded by the National Key Research and Development Program of China (No. 2018YFC1315302, 2017YFC 1200502); the National Natural Science Foundation of China (Grant No. 81773552). Declaration of Interests: The authors have declared that no competing interests exist.