Abstract
OBJECTIVE: To analyze trends in the global burden (GBD) of ischemic heart disease (IHD) over the past 30 years and health inequalities, as well as to predict the trends for the next 25 years. METHODS: Data on the incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), and risk factors for IHD were obtained from GBD 2021. Changing global, regional, and national trends from 1990 to 2021 were analyzed, accompanied by decomposition analysis. Potential for improvement was assessed using frontier analysis while conducting a regional risk factor ranking analysis. Joinpoint software and an age-period-cohort model were used to analyze IHD data further. Finally, future IHD trends were analyzed using the prediction models such as the Bayesian age-period-cohort analysis (BAPC) model. RESULTS: According to GBD 2021, the global incidence of IHD cases was 31,872,778 (201.6%, compared to 1990), with 254,276,268 prevalent cases (226.7%, compared to 1990), 188,360,557 DALYs (158.1%, compared to 1990), and 8,991,637 deaths (167.5%, compared to 1990). Significant changes were noted in Uzbekistan, China, and Indonesia. Male patients outnumbered females, and most were over 60. In 2021, the total amount of IHD was primarily driven by ageing and population growth, with substantial potential for improvement observed in middle and high Socio-Demographic Index (SDI) regions; future attention should also be directed toward occupational risks, air quality, and renal dysfunction's impact on IHD. The BAPC method showed that the incidence of IHD would reach 56,431,619 cases by 2046. This would be 1.77 times the number of cases in 2021. CONCLUSION: From 1990 to 2021, the number of IHD cases in the world and its forecast analysis showed an upward trend, mainly affected by population growth and aging. The disparity of medical burden in areas with low, middle and medium development levels is worsening. The importance of regional rankings of risk factors for IHD has also shifted due to global economic changes over the past 30 years. This study highlights the challenges faced in managing IHD and calls for governments and institutions to adopt multidimensional public health strategies encompassing age, risk factors, gender, and predictive models to address the growing number of cases and other health problems. These findings will guide health policies to effectively control clinical stress in IHD by prioritizing regional risk factors for targeted interventions and individualized prevention for high-risk populations, while also ensuring efficient use of health resources.