Burden Of Ischemic Heart Disease Research Articles

Burden of Ischemic Heart Diseases among US States from 1990-2019.

Ischemic Heart Disease (IHD) is a leading cause of global mortality, including in the United States. Understanding the burden of IHD in the United States is crucial for informed decision-making and targeted interventions aimed at reducing morbidity and mortality associated with this leading cause of death. This study aimed to understand the burden of IHD, identify gender disparities and risk factors, explore the relationship between socioeconomic growth and IHD, and analyze risk factor distribution across the states of the United States. This study utilized data from the Global Burden of Diseases Study 2019, which provided comprehensive information on IHD from 1990 to 2019. Data related to IHD from these years were extracted using a query tool from the Institute for Health Metrics and Evaluation (IHME) website. The study assessed the relationship between IHD and socioeconomic development using the Socio-demographic Index (SDI) and measured the overall impact of IHD using Disability-adjusted Life Years (DALYs), considering premature death and disability. Additionally, the study analyzed the burden of IHD attributed to six main risk factors. Data analysis involved comparing prevalence, mortality, SDI, DALYs, attributable burden, and risk estimation among the states. Between 1990 and 2019, there was an improvement in socioeconomic development in all states. Age-standardized rates of disease burden for IHD decreased by 50% [ASDR 3278.3 to 1629.4 (95% UI: 1539.9-1712.3) per 100,000] with the most significant decline observed in Minnesota. Males had higher burden rates than females in all states, and the southeast region had the highest mortality rates. The prevalence of IHD showed a declining trend, with approximately 8.9 million cases (95% UI: 8.0 million to 9.8 million) in 2019, representing a 37.1% decrease in the Age-standardized Prevalence Rate (ASPR) from 1990. Metabolic risks were the leading contributors to the disease burden, accounting for 50% of cases, with Mississippi having the highest attributable risk. Arkansas had the highest attributable risk for high cholesterol and smoking. Conversely, Minnesota had the lowest burden of IHD among all the states. This study highlights variations in the burden of IHD across US states and emphasizes the need for tailored prevention programs to address specific risk factors and gender differences. Understanding the trend in IHD may inform policymakers and healthcare professionals in effectively allocating resources to reduce the burden of IHD and improve national health outcomes.

Temporal trends in the prevalence and death of ischemic heart disease in women of childbearing age from 1990 to 2019: a multilevel analysis based on the Global Burden of Disease Study 2019.

Our objective is to describe the current prevalence and death of ischemic heart disease (IHD) in women of childbearing age (WCBA) at the global, regional, and national levels and to analyze its temporal trends from 1990 to 2019. WCBA was defined as women aged 15-49 years. Estimates and 95% Uncertainty Intervals (UI) of IHD prevalence and death numbers for seven age groups were extracted from the 2019 Global Burden of Disease Study. The age-standardized prevalence and death rate (ASPR and ASDR) of IHD in WCBA was estimated using the direct age-standardization method. Joinpoint regression analysis was used to calculate average annual percent change (AAPC) to represent the temporal trends from 1990 to 2019. Between 1990 and 2019, the global ASPR of IHD experienced a 3.21% increase, culminating in 367.21 (95% UI, 295.74-430.16) cases per 100,000 individuals. Conversely, the ASDR decreased to 11.11 (95% UI, 10.10-12.30) per 100,000 individuals. In 2019, among the five sociodemographic index (SDI) regions, the highest ASPR was observed in the high-middle SDI region, whereas the highest ASDR was found in the low-middle SDI region. Regionally, the Caribbean reported the highest ASPR (563.11 per 100,000 individuals; 95% UI, 493.13-643.03), and Oceania reported the highest ASDR (20.20 per 100,000 individuals; 95% UI, 13.01-31.03). At the national level, Trinidad and Tobago exhibited the highest ASPR (730.15 per 100,000 individuals; 95% UI, 633.96-840.13), and the Solomon Islands had the highest ASDR (77.77 per 100,000 individuals; 95% UI, 47.80-121.19). Importantly, over the past three decades, the global ASPR has seen a significant increase [AAPC = 0.11%, 95% Confidence Interval (CI): 0.09-0.13; P < 0.001], while the ASDR has demonstrated a significant decreasing trend (AAPC = -0.86%, 95% CI: -1.11 to -0.61; P < 0.001). Air pollution, tobacco use, high systolic blood pressure, elevated body mass index, dietary risks, and high LDL cholesterol have been identified as the leading six risk factors for IHD-related deaths among WCBA in 2019. Despite the significant decline in the global ASDR for IHD among WCBA over the last thirty years, the ASPR continues to escalate. We need to remain vigilant about the increased burden of IHD in WCBA. It calls for aggressive prevention strategies, rigorous control of risk factors, and the enhancement of healthcare coverage to mitigate the disease burden of IHD among WCBA in forthcoming years.

The global burden of ischemic heart disease attributed to high fasting plasma glucose: Data from 1990 to 2019

BackgroundIschemic heart disease (IHD) is the leading cause of death worldwide. High fasting plasma glucose (FPG) is an increasing risk factor for IHD. We aimed to explore the long-term trends of high FPG-attributed IHD mortality during 1990–2019. MethodsData were obtained from the Global Burden of Disease Study 2019 database. Deaths, disability-adjusted life-years (DALYs), the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of IHD attributable to high FPG were estimated by sex, socio-demographic index (SDI), regions and age. Estimated annual percentage changes (EAPCs) were calculated to assess the trends of ASMR and ASDR of IHD attributable to high FPG. ResultsIHD attributable to high FPG deaths increased from 1.04 million (0.62–1.63) in 1990 to 2.35 million (1.4–3.7) in 2019, and the corresponding DALYs rose from 19.82 million (12.68–29.4) to 43.3 million (27.8–64.2). In 2019, ASMR and ASDR of IHD burden attributable to high FPG were 30.45 (17.09–49.03) and 534.8 (340.7–792.2), respectively. The highest ASMR and ASDR of IHD attributable to high FPG occurred in low-middle SDI quintiles, with 39.28 (22.40–62.76) and 742.3 (461.5–1117.5), respectively, followed by low SDI quintiles and middle SDI quintiles. Males had higher ASMR and ASDR compared to females across the past 30 years. In addition, ASRs of DALYs and deaths were highest in those over 95 years old. ConclusionHigh FPG-attributed IHD mortality and DALYs have increased dramatically and globally, particularly in low, low-middle SDI quintiles and among the elderly. High FPG remains a great concern on the global burden of IHD and effective prevention and interventions are urgently needed to curb the ranking IHD burden, especially in lower SDI regions.

Burden of ischaemic heart disease and attributable risk factors among Nanjing adults in China from 2011 to 2017

Burden of ischaemic heart disease and attributable risk factors among Nanjing adults in China from 2011 to 2017

Men with nonobstructive coronary disease have higher burden of ischemic heart disease detected by cardiopulmonary exercise test.

Nonobstructive coronary artery disease (NOCAD), characterized by the presence of myocardial ischemic symptoms and signs without obstructive coronaries, is a common clinical condition, but it is less well understood. Few studies have analyzed the gender differences in inducible myocardial ischemia assessed by cardiopulmonary exercise test (CPET) in NOCAD. We conducted a study of 289 NOCAD patients (mean age 60, 56% women) with ischemic symptoms and confirmed ⫹50% coronaries stenoses by coronary angiography who underwent symptom-limited CPET. We assessed ischemic response using predicted % peak VO2 , O2 pulse trajectory, and exercise ECG test. Men with NOCAD had significantly lower predicted % peak VO2 (62% vs. 73%), higher proportions of flattening pattern (16% vs. 2%), and downward patterns of O2 pulse trajectory (2% vs. 0%) (p < .0001) compared with women. In contrast, women with NOCAD had a higher prevalence of shallow patterns of O2 pulse trajectory (21% vs. 6%, p < .0001). Men with NOCAD had a higher risk ischemic profile (medium risk: 63% vs. 54%, high risk: 18% vs. 4%, p < .0001). After adjustment, men with NOCAD had significantly lower predicted % peak VO2 (β -27.4, 95% CI -30.74 to -24.07), higher risk for abnormal O2 pulse trajectories (OR 4.21, 95% CI 1.93 to 9.19), and myocardial ischemia risk per CPET parameters (OR 3.14, 95% CI 1.78 to 5.54) (p < .0001). Men with NOCAD had a higher risk profile for ischemic heart disease per CPET. Therefore, they should receive rigorous management and follow-up to prevent cardiovascular events.

Global, regional, and national burden of ischemic heart disease attributable to secondhand smoke from 1990 to 2019.

Assessing the burden of ischemic heart disease (IHD) attributable to secondhand smoke (SHS) exposure is crucial for informing evidence-based healthcare practices, prevention strategies, and resource allocation planning. The burden of IHD attributable to SHS from 1990 to 2019 was assessed using the comparative risk assessment method as part of the Global Burden of Disease (GBD) study 2019. Globally, the absolute number of deaths and disability-adjusted life-years (DALYs) from IHD due to SHS increased substantially from 270.0 thousand and 6971.3 thousand in 1990 to 397.4 thousand and 9566.1 thousand in 2019. The corresponding age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) were both in a decreasing trend with estimate of the annual percentage change (EAPC) of -1.38 (-1.42 - -1.34) and -1.43 (-1.47 - -1.38). Central Asia has the highest ASMR (16 per 100000, 95% uncertainty interval, UI: 12.8-19.4), and Oceania has the highest ASDR (323.2 per 100000, 95% UI: 228.9-443.1 per 100000) in 2019. All sociodemographic index (SDI) category regions showed a decreasing trend in ASMR and ASDR, with the decrease being more obvious in high and high-middle SDI regions. Our analysis identified an escalating trend concerning ASMR and ASDR in Oceania from 1990 to 2019. In 2019, the most significant number of deaths and DALYs occurred in the age group of 80-84 years (5.4 thousand, 95% UI: 3.7-7.3 in thousands) and the age group of 55-59 years (1140.8 thousand, 95% UI: 876.1-1435 in thousands). Our study reveals an absolute global increase in deaths and DALYs from IHD due to SHS from 1990 to 2019. Despite a declining trend in ASMR and ASDR, regional disparities persist. The elderly and middle-aged populations bore the most significant burden. These findings highlight the ongoing global health impact of SHS on IHD and emphasize the need for targeted interventions in regions with rising trends and vulnerable age groups.

Epidemiological characterization of ischemic heart disease at different altitudes: A nationwide population-based analysis from 2011 to 2021 in Ecuador.

Cardiovascular diseases, including ischemic heart disease, are the leading cause of premature death and disability worldwide. While traditional risk factors such as smoking, obesity, and diabetes have been thoroughly investigated, non-traditional risk factors like high-altitude exposure remain underexplored. This study aims to examine the incidence and mortality rates of ischemic heart disease over the past decade in Ecuador, a country with a diverse altitude profile spanning from 0 to 4,300 meters. We conducted a geographic distribution analysis of ischemic heart disease in Ecuador, utilizing hospital discharge and mortality data from the National Institute of Census and Statistics for the years 2011-2021. Altitude exposure was categorized according to two distinct classifications: the traditional division into low (< 2,500 m) and high (> 2,500 m) altitudes, as well as the classification proposed by the International Society of Mountain Medicine, which delineates low (< 1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m), and very high (3,500-5,800 m) altitudes. From 2011-2021, we analyzed 49,765 IHD-related hospital admissions and 62,620 deaths. Men had an age-adjusted incidence rate of 55.08/100,000 and a mortality rate of 47.2/100,000, compared to 20.77/100,000 and 34.8/100,000 in women. Incidence and mortality surged in 2020 by 83% in men and 75% in women. Altitudinal stratification revealed higher IHD rates at lower altitudes (<2500 m), averaging 61.65 and 121.8 per 100,000 for incidence and mortality, which declined to 25.9 and 38.5 at elevations >2500 m. Men had more pronounced rates across altitudes, exhibiting 138.7% and 150.0% higher incidence at low and high altitudes respectively, and mortality rates increased by 48.3% at low altitudes and 23.2% at high altitudes relative to women. Ecuador bears a significant burden of ischemic heart disease (IHD), with men being more affected than women in terms of incidence. However, women have a higher percentage of mortality post-hospital admission. Regarding elevation, our analysis, using two different altitude cutoff points, reveals higher mortality rates in low-altitude regions compared to high-altitude areas, suggesting a potential protective effect of high elevation on IHD risk. Nevertheless, a definitive dose-response relationship between high altitude and reduced IHD risk could not be conclusively established.

Burden of ischemic heart disease in the Middle East and North Africa (MENA) and attributable risk factors: An epidemiological analysis from 1990 to 2019

IntroductionDespite the burden of ischemic heart disease (IHD), there remains a paucity of research on the incidence, mortality, and burden of this condition in the Middle East and North Africa (MENA) regions. This study aimed to evaluate the epidemiology and the risk factors associated with IHD in the MENA region. MethodsThis study was performed based on the GBD study 2019 data. We retrieved the data related to the epidemiology and burden of IHD, including prevalence, incidence, years of life lost due to premature death (YLLs), years lived with disability (YLDs), and mortality at the global level and in MENA countries across years and sexes. ResultsIHD accounted for approximately 2.55 million (95 % UI 2.29–2.83) incident cases in MENA in 2019, with an age-standardized incidence rate of 613.87 (95 % UI 555.84–675.16) per 100 000 people, which has decreased by 9 % between 1990 and 2019. IHD accounted for 11.01 % of DALYs causes in MENA in 2019, an increase of 68 % compared to 1990. The DALYs rate from IHD increased with age in both men and women and was higher in men than in women in all age groups, except 85–89 years age-group, in 2019. ConclusionThe age-standardized prevalence and incidence of IHD are decreasing in MENA. However, this reduction is lower than the global level, which can be due to a weaker performance of the countries in the region in reducing the prevalence and incidence of the disease compared to the global average.

Global Burden of Ischemic Heart Disease in Adolescents and Young Adults, 1990–2019

Few studies have evaluated the global burden of ischemic heart disease (IHD) in adolescents and young adults (AYAs). Age-standardized rates (ASRs) of incidence (ASIR), mortality (ASMR) and Disability-Adjusted Life Years (DALYs) (ASDR) were used to describe the burden of IHD in AYAs. Estimated Annual Percentage Changes (EAPCs) of ASRs were used to describe the trend from 1990 to 2019. Risk factors were calculated by population attributable fractions (PAFs). Analyses were conducted in 2023. In 2019, the ASIR, ASMR, and ASDR of IHD in AYAs were 26.81 (95% uncertainty interval [UI]: 20.36-34.54) per 100,000, 7.15 (95% UI: 6.56-7.87) per 100,000 and 409.51 (95% UI: 376.57-449.59) per 100,000. The ASIR and ASMR were higher among men than among women. From 1990 to 2019, the ASIR increased (EAPC=0.18%, 95% CI 0.14%-0.22%), while the ASMR (EAPC=-0.39%, -0.50% to -0.27%) and ASDR (EAPC=-0.40%, -0.52% to -0.29%) decreased. The largest increase in ASIR was observed in countries with a middle sociodemographic index (SDI) (EAPC=0.56%, 0.51%-0.60%). Globally, the proportional contribution of risk factors for DALY varied across regions, with the highest proportions of high low-density lipoprotein cholesterol in high SDI regions (PAF=74.26%) and high-middle (PAF=71.30%) and the highest proportions of air pollution in low (PAF=41.79%) and low-middle SDI regions (PAF=40.90%). The burden of IHD in AYAs remains high globally, and varies by age, sex, (male/female), region, and country. Targeted measures are needed to address the rising burden of IHD in AYAs, focusing on prevention, early diagnosis, and reduction in disparities.

Global burden of ischemic heart disease associated with high red and processed meat consumption: an analysis of 204 countries and territories between 1990 and 2019

BackgroundMultiple studies have indicated an association between red and processed meat consumption and the incidence of ischemic heart disease (IHD). In this study, we aimed to assess the burden of IHD caused by a diet high in red and processed meat in 204 countries and territories between 1990 and 2019, using data from the Global Burden of Disease (GBD) 2019.MethodsWe extracted data from the GBD 2019, which included the number of deaths, age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and age-standardized DALYs rates (ASDR) attributed to IHD caused by a diet high in red and processed meat. We then calculated the burden of IHD attributable to a high intake of red and processed meat in each country and territory, stratified by age, sex, and socio-demographic index (SDI).ResultsGlobally, a high intake of red meat was responsible for 351,200 (95% uncertainty interval (UI): 559,000–642,700) deaths from IHD in 2019, while a high intake of processed meat was associated with 171,700 (95% UI: 30,100–320,000) deaths from IHD. Between 1990 and 2019, while the corresponding age-standardized rates declined, the numbers of deaths and DALYs increased. China had the highest number of deaths [98,386.9 (95% UI: 14,999.3–189,812.7)] caused by a high intake of red meat, while United States of America [33,129.6 (95% UI: 7,150–59,593.8)] was associated with the highest number of deaths caused by high intake of processed meat for IHD in 2019. Males experienced a greater burden of IHD caused by a high intake of red and processed meat than females. The ASMR and ASDR of IHD attributed to a high intake of red meat decreased in countries with high SDI, high-middle SDI and low SDI, while the ASMR and ASDR of IHD attributed to a high intake of processed meat decreased only in countries with high SDI and high-middle SDI.ConclusionAlthough there is a decline in the ASMR and ASDR of IHD caused by a high intake of red and processed meat, there is also an increase in deaths and DALYs number globally. Additionally, there is a heterogeneous burden of IHD related to a high intake of red and processed meat across regions and countries, with males experiencing a greater burden than females. Implementing targeted policies and interventions is required to reduce the burden of IHD caused by a high intake of red and processed meat.

Global, regional, and national burden of ischemic heart disease attributable to ambient PM2.5 from 1990 to 2019: An analysis for the global burden of disease study 2019

Information on the spatio-temporal patterns of the burden of ischemic heart disease (IHD) caused by ambient ambient fine particulate matter (PM2.5) in the global level is needed to prioritize the control of ambient air pollution and prevent the burden of IHD. The Global Burden of Disease Study (GBD) 2019 provides data on IHD attributable to ambient PM2.5. The IHD burden and mortality attributable to ambient PM2.5 were analyzed by year, age, gender, socio-demographic index (SDI) level, geographical region and country. Estimated annual percentage change (EAPC) was calculated to estimate the temporal trends of age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) from 1990 to 2019. Globally, the ASMR and ASDR for ambient PM2.5-related IHD tended to level off generally, with EAPC of −0.03 (95% CI: −0.06, 0.12) and 0.3 (95% CI: 0.22, 0.37), respectively. In the past 30 years, there were obvious differences in the trend of burden change among different regions. A highest increased burden was estimated in low-middle SDI region (EAPC of ASMR: 3.73 [95% CI: 3.56, 3.9], EAPC of ASDR: 3.83 [95% CI: 3.64, 4.02]). In contrast, the burden in high SDI region (EAPC of ASMR: −4.48 [95% CI: −4.6, −4.35], EAPC of ASDR: −3.98 [95% CI: −4.12, −3.85]) has declined most significantly. Moreover, this burden was higher among men and older populations. EAPCs of the ASMR (R = −0.776, p < 0.001) and ASDR (R = −0.781, p < 0.001) of this burden had significant negative correlations with the countries’ SDI level. In summary, although trends in the global burden of IHD attributable to ambient PM2.5 are stabilizing, but this burden has shifted from high SDI countries to middle and low SDI countries, especially among men and elderly populations. To reduce this burden, the air pollution management prevention need to be further strengthened, especially among males, older populations, and middle and low SDI countries.

Burden of Ischemic Heart Disease and Its Attributable Risk Factors in North Africa and the Middle East, 1990 to 2019: Results From the GBD Study 2019.

The North Africa and Middle East (NAME) region has one of the highest burdens of ischemic heart disease (IHD) worldwide. This study reports the contemporary epidemiology of IHD in NAME. We estimated the incidence, prevalence, deaths, years of life lost, years lived with disability, disability-adjusted life years (DALYs), and premature mortality of IHD, and its attributable risk factors in NAME from 1990 to 2019 using the results of the GBD (Global Burden of Disease study 2019). In 2019, 0.8 million lives and 18.0 million DALYs were lost due to IHD in NAME. From 1990 to 2019, the age-standardized DALY rate of IHD significantly decreased by 33.3%, mostly due to the reduction of years of life lost rather than years lived with disability. In 2019, the proportion of premature death attributable to IHD was higher in NAME compared with global measures: 26.8% versus 16.9% for women and 18.4% versus 14.8% for men, respectively. The age-standardized DALY rate of IHD attributed to metabolic risks, behavioral risks, and environmental/occupational risks significantly decreased by 28.7%, 37.8%, and 36.4%, respectively. Dietary risk factors, high systolic blood pressure, and high low-density lipoprotein cholesterol were the top 3 risks contributing to the IHD burden in most countries of NAME in 2019. In 2019, IHD was the leading cause of death and lost DALYs in NAME, where premature death due to IHD was greater than the global average. Despite the great reduction in the age-standardized DALYs of IHD in NAME from 1990 to 2019, this region still had the second-highest burden of IHD in 2019 globally.

Abstract 18097: The Burden of Ischemic Heart Disease in North Africa and Middle East Region From 1990-2019: Results From the GBD Study

BACKGROUND: Despite the substantial burden of IHD in North Africa and Middle East (NAME) region, temporal trends of the burden of IHD were not systematically evaluated in this region and its countries previously. Methods: We reported deaths, premature mortality, YLLs, YLDs, and DALYs of IHD in NAME region and its 21 countries during 1990-2019 using the results of the Global Burden of Disease Study 2019. Premature IHD mortality was defined as IHD death in males &lt;55 and females &lt;65 years of age. Results: IHD accounted for 0.8 million deaths and 18 million DALYs in NAME in 2019. From 1990-2019, the age-standardized death rate of IHD significantly decreased by 29% (-37 to -22) and reached 219 (194 to 247) per 100,000 in NAME in 2019 (Fig A) compared with the global estimates of -31% (-35 to -27) and 118 (108 to 126), respectively. From 1990-2019, the age-standardized DALY rate of IHD significantly decreased by 33% (95% CI: -41 to -25) and reached 4159 (3651 to 4752) per 100,000 population in NAME in 2019 (Fig B) compared with the global estimates of -29% (-33 to -24) and 2243 (2099 to 2385), respectively. The reduction in age-standardized DALY was mostly derived from the reduction in YLL (-34%) rather than YLD (-4%) compared with worldwide estimates of -29% and -6%. While the decreasing pattern in the age-standardized DALY and death rate of IHD was consistently observed across all 21 NAME countries, it was not statistically significant for Egypt, Libya, Saudi Arabia, Syria, Tunisia, and Yemen (Fig C, D). In 2019, 27% of IHD deaths in females and 18% of IHD deaths in males were premature in NAME, which was higher than the worldwide estimates of 17% and 15%, respectively. Turkey, Iran, and Lebanon showed the greatest reduction in IHD premature mortality during 1990-2019. CONCLUSIONS: Despite the improvements, IHD still remains the leading cause of lost death and DALYs in NAME. People are more likely to die prematurely due to IHD with more pronounced sex disparities in NAME compared with the global average.

Abstract 13720: Global Burden, Trends, and Attributable Risk Factors for Ischemic Heart Disease, 1990~2019: A Systemic Analysis of the Global Burden of Disease Study 2019

Background: As the primary culprit for nearly half of global cardiovascular deaths, ischemic heart disease (IHD) exerts a significant medical and economic toll, particularly on low- and middle-income countries. The rise in IHD incidence and mortality from 1990 to 2019 necessitates revising analyses and developing effective IHD strategies. Research Questions: To categorize IHD incidence, mortality, and Disability-Adjusted Life Years by country, sex, age, and Sociodemographic Index (SDI) from 1990-2019. To identify key risk factors and establish a model predicting IHD incidence till 2044.Aims: To assess global IHD incidence, dissect disease burden distribution, identify central risk factors, and forecast incidence trends. Methods: Leveraging the Global Burden of Disease (GBD) database for global population and IHD data from 1990 to 2019, we explored regional, gender, age attributes, and IHD temporal progression. We utilized a joinpoint model and an age-period-cohort model to decipher IHD incidence trends, scrutinized primary IHD risk factors, and predicted global IHD incidence till 2044. Results: Global age-standardized IHD incidence decreased from 316 (95% UI 282-352) in 1990 to 262 (95% UI 233-293) in 2019, primarily due to high SDI and high-middle SDI regions. Men had higher IHD incidence across all ages, notably between 35-74. Diet remained the leading risk factor from 1990 to 2019. Projections suggest a steady global IHD incidence similar to 2019 levels by 2044. Conclusions: Future trends indicate the IHD burden will concentrate in middle or lower SDI regions, with stable global IHD incidence over the next two decades. Joint initiatives to mitigate IHD's burden are vital, demanding specific policies and interventions. The GBD database is instrumental for health priority strategies. Collective efforts can lead us towards sustainable development and improved global health.

Abstract 13982: Ischemic Heart Disease Burden in the United States: Prevalence, Mortality, and Regional Differences From 1990-2019

Background: Understanding the burden of IHD in the United States is crucial for informed decision-making and targeted interventions aimed at reducing morbidity and mortality. Aim: To understand the burden of IHD, identify gender disparities and risk factors, explore the relationship between socioeconomic growth and IHD, and analyze risk factor distribution across states. Method: utilizing data from the GBD Study 2019. The study assessed the relationship between IHD and socioeconomic development using SDI and measured the overall impact of IHD using DALYs, considering premature death and disability. Data analysis involved comparing prevalence, mortality, SDI, DALYs, attributable burden, and risk estimation among states. Results: Between 1990 and 2019, there was an improvement in socioeconomic development in all states. Age-standardized rates of disease burden for IHD decreased by 50% with the most significant decline observed in Minnesota. Males had higher burden rates than females in all states, and the southeast region had the highest mortality rates. The prevalence of IHD showed a declining trend with a 37.1% decrease in ASPR from 1990. Metabolic risks were the leading contributors to the disease burden, accounting for 50% of cases, with Mississippi having the highest attributable risk. Arkansas had the highest attributable risk for high cholesterol and smoking. Conversely, Minnesota had the lowest burden of IHD among all states. Conclusion: This study highlights variations in the burden of IHD across US states and emphasizes the need for tailored prevention programs to address specific risk factors and gender differences.

Abstract 19042: Statewide Burden of Ischemic Heart Disease Attributable to Dietary Risk Factors From 1990-2019 in United States: A Systematic and Comparative Benchmarking Study

Introduction: Ischemic Heart Disease (IHD) is the 1 st leading cause of deaths among all causalities in United states (US). However, there is a large statewide variation within the US due to IHD attributable to dietary risk factors. Comparable and consistent state-level burden of total IHD attributable to dietary risk factors have not been produced previously. Methods: Using Global Burden of Disease methodology, deaths, and disability adjusted life years (DALYs) due to IHD attributable to dietary risk factors were analyzed by age group, sex, year, and location across the US from 1990-2019. Results were presented in all age counts and age standardized rate per 100,000 person years. Results: The annual percentage of change (APC) in total DALYs increased by 32% for IHD attributable to a high sodium diet, followed by a 10% increase for a diet high in sugar-sweetened beverages and a 2% increase for a diet low in vegetables. In terms of total deaths, the highest APC increase was observed in Nevada (142%), followed by Alaska (98%) and Arizona (65%). Conversely, the District of Columbia and Nebraska had the lowest APC increases in total DALYs and deaths. Regarding age groups, the highest APC increase in the total number of deaths was seen in the 95+ year group (97%), followed by the 90-94 age (44%), 55-59 age (10%), and 50-54 age (3%). Conclusions: Statewide disparities of IHD attributable to dietary risk factors in the US is significant and calls for comprehensive public health strategies. By addressing the root causes and promoting healthier dietary habits, it is possible to reduce the burden of IHD, improve population health outcomes, and alleviate the strain on healthcare systems and the economy.

The burden of ischemic heart disease attributable to ambient and household particulate matter pollution, 1990-2019: a global analysis.

Elevated risk of ischemic heart disease (IHD) is associated with exposure to fine particulate matter. However, there is limited data on trends and comparisons in the global burden of IHD due to household air pollution from solid fuels (HAP) and ambient particulate matter pollution (APMP), particularly in regions of varying socio-economic levels. Based on the Global Burden of Disease Study 2019 (GBD 2019), we obtained age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (ASDR) of IHD due to APMP and HAP from 1990 to 2019. Trends in the burden of IHD attributable to APMP and HAP during the period 1990 to 2019 were calculated by Joinpoint models. We estimated the relationship between ASMR with the socio-demographic indexes (SDI) and the health care accessibility and quality (HAQ) index by the Loess regression model. In 2019, the global burden of IHD ASMR attributed to APMP stabilized, but the most significant increases were observed in low-middle SDI regions. The global IHD ASMR attributed to APMP was 16.60 [95% Uncertainty Interval (UI), 13.61 to 19.44] per 100,000 population, with the highest APMP burden in middle SDI regions. From 1990 to 2019, the global ASMR for HAP-attributable IHD declined. The global ASMR of IHD attributable to HAP in 2019 was 6.30 (95% UI, 4.28 to 8.80) per 100,000 population, with the highest burden observed in the low SDI regions. From 1990 to 2019, the global burden of ASMR and ASDR of IHD attributable to APMP showed stabilization, whereas the HAP burden exhibited a decrease. There are a large burden of APMP particularly in middle SDI countries and a higher burden of HAP in low SDI countries. The burden of IHD due to APMP and HAP in men, the elderly, and populations in low, medium, and low SDI regions should be noticed.

The burden of ischemic heart disease and the epidemiologic transition in the Eastern Mediterranean Region: 1990-2019.

It has been estimated that in the next decade, IHD prevalence, DALYs and deaths will increase more significantly in EMR than in any other region of the world. This study aims to provide a comprehensive description of the trends in the burden of ischemic heart disease (IHD) across the countries of the Eastern Mediterranean Region (EMR) from 1990 to 2019. Data on IHD prevalence, disability-adjusted life years (DALYs), mortality, DALYs attributable to risk factors, healthcare access and quality index (HAQ), and universal health coverage (UHC) were extracted from the Global Burden of Disease (GBD) database for EMR countries. The data were stratified based on the social demographic index (SDI). Information on cardiac rehabilitation was obtained from publications by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR), and additional country-specific data were obtained through advanced search methods. Age standardization was performed using the direct method, applying the estimated age structure of the global population from 2019. Uncertainty intervals were calculated through 1000 iterations, and the 2.5th and 97.5th percentiles were derived from these calculations. The age-standardized prevalence of IHD in the EMR increased from 5.0% to 5.5% between 1990 and 2019, while it decreased at the global level. In the EMR, the age-standardized rates of IHD mortality and DALYs decreased by 11.4% and 15.4%, respectively, during the study period, although both rates remained higher than the global rates. The burden of IHD was found to be higher in males compared to females. Bahrain exhibited the highest decrease in age-standardized prevalence (-3.7%), mortality (-65.0%), and DALYs (-69.1%) rates among the EMR countries. Conversely, Oman experienced the highest increase in prevalence (14.5%), while Pakistan had the greatest increase in mortality (30.0%) and DALYs (32.0%) rates. The top three risk factors contributing to IHD DALYs in the EMR in 2019 were high systolic blood pressure, high low-density lipoprotein cholesterol, and particulate matter pollution. The trend analysis over the 29-year period (1990-2019) revealed that high fasting plasma glucose (64.0%) and high body mass index (23.4%) exhibited increasing trends as attributed risk factors for IHD DALYs in the EMR. Our findings indicate an increasing trend in the prevalence of IHD and a decrease in mortality and DALYs in the EMR. These results emphasize the need for well-planned prevention and treatment strategies to address the risk factors associated with IHD. It is crucial for the countries in this region to prioritize the development and implementation of programs focused on health promotion, education, prevention, and medical care.

Abstract P404: Statewide Burden Of Ischemic Heart Disease Attributable To High Blood Pressure In United States From 1990-2019: A Benchmarking And Comparative Analysis For The Gbd 2019

Background: Ischemic Heart Disease (IHD) is the 1 st leading cause of death across the United States accounting for 18.9% of all casualties. The burden of IHD due to hypertension (HTN) in the United States is significant and multifaceted. Method: Using Global Burden of Disease methodology, deaths and disability adjusted life years (DALY) were assessed by age, sex and year across the US from 1990-2019. Results: Total number of deaths due to IHD attributable to HTN decreased from 343,151 in 1990 to 252,093 in 2019, DALYs decreased from 5,877,382 to 4,115,645 from 1990-2019. The age standardized death rate (ASMR) decreased from 102 to 41 per 100,000 person year 1990-2019. The highest annual percentage change (APC) increase in deaths observed in Nevada 88% (1217-2,283) followed by Alaska, Arizona from 1990-2019. Conclusion: IHD due to HTN found to be the leading cause of deaths across the US. Despite significant advancements in the management of IHD, the burden of IHD attributable to HTN remains a major health concern across the United States.

The Pandemic of Coronary Artery Disease in the Sub-Saharan Africa: What Clinicians Need to Know.

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally with an accelerated increase in CVD‑related death in Africa and other low‑middle‑income countries. This review is aimed at highlighting the burden of coronary artery disease CAD, its peculiarities as well as challenges of management in sub-Saharan Africa. Recent data revealed a shift from high incidence of CVDs associated with poverty and malnutrition (such as rheumatic heart disease) initially, which are now falling, to rising incidence of other non-communicable CVDs (such as hypertension, coronary artery disease (CAD), and heart failure). Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide, which is projected to supersede communicable diseases in the future. Previous studies have shown that CAD was rare among Africans. Those studies conducted in Africa in the 1940s-1960s reported that Black Africans were almost immune to developing CAD and were even thought to have specific genetic make-up protecting them from CAD. However, the continent is now experiencing a steady rise in the prevalence of CAD associated with severe disease burden, compared to other regions of the world. The changes seen have been attributed to the current epidemiological transition with increase in CVD risk factors that are poorly controlled, lack of awareness as well as the poor health facilities to tackle the menace of the disease. The Global Burden of Disease (GBD) estimates have also shown that over the past three decades the highest contribution to CVD burden in Africa is attributed to atherosclerotic diseases, with 71.4, 37.7, and 154% increases in the burden of ischemic heart disease, stroke, and peripheral artery disease respectively. There is a steady increase of CAD prevalence in Africa as a result of increase in CV risk factors. Hypertension, obesity, diabetes, dyslipidemia, and cigarette smoking are the rapidly rising risk factors for CAD on the continent. Africa also faces challenges in diagnosis and management of CAD. There is need for increased public and health personnel awareness on prevention and control of commonly identifiable risk factors, provision of prehospital emergency services, and provision of modern therapeutic facilities for treatment of CAD including reperfusion therapy. These are priority areas where efforts could be intensified in the future with potential to improve the current rate of progress of the disease on the continent.