Abstract
OBJECTIVE: To assess the burden of ischemic heart disease (IHD) in Belt and Road Initiative countries from 1990 to 2021 and to predict future trends. METHODS: Utilizing data from GBD 2021, we analyzed incidence, mortality, and other indicators using Joinpoint analysis, NetDrift methodology, age-period-cohort models, and Bayesian Age-Period-Cohort (BAPC) predictive modeling. RESULTS: In 2021, China bore the heaviest IHD burden with an incidence of 7.3 million cases and a mortality rate of 1.96 million. The United Arab Emirates experienced over a tenfold increase in incidence/prevalence rates, while Djibouti saw a fivefold rise in deaths/DALYs. Uzbekistan's standardized incidence rate increased by 107.2%, and Lesotho's mortality rate rose by 78.7%. A higher proportion of affected individuals were male or aged over 60 years; aging populations and demographic growth emerged as primary driving factors. Low/medium-low SDI regions exhibited significant potential for improvement; emerging risks included renal insufficiency and low grain diets. Projections indicate that by 2046, the number of IHD cases in China may exceed 14,410,378 individuals, highlighting a severe prevention and control challenge. CONCLUSION: The burden of IHD demonstrates regional disparities characterized by the interplay between traditional risk factors and emerging threats. It is recommended to establish a stratified governance framework that enhances cross-national data sharing and facilitates the transfer of digital health technologies to optimize cardiovascular disease prevention strategies.