Abstract
AIM: This study aimed to estimate the distribution of and changes in the global burden of ischaemic heart disease (IHD) attributable to high body mass index (BMI) and low physical activity (PA) from 1990 to 2021. METHODS: Data on deaths, disability-adjusted life years (DALYs) and age-standardized rates for IHD attributable to high BMI and low PA were extracted from the Global Burden of Disease 2021 study. Temporal trends by gender, region and Socio-Demographic Index (SDI) were analysed using joinpoint regression. Decomposition, health inequality analysis and Bayesian model were utilized. RESULTS: From 1990 to 2021, global DALYs and deaths for IHD attributable to high BMI and low PA nearly doubled, despite a decline in age-standardized DALYs ([average annual percent change (AAPC) = -0.26, 95% uncertainty interval (95% UI): -0.45, -0.07), (AAPC = -1.03, 95% UI:-1.18, -0.88]) and deaths rates ([AAPC = -0.53, 95% UI: -0.72, -0.33], [AAPC = -1.13,95% UI: -1.34, -0.92]), respectively. The burden of IHD due to high BMI was predominantly seen in males, while low PA was more prevalent in females. Significant regional and national variation was observed, with the burden shifting from high SDI regions to middle or low SDI regions. Population growth and aging have exacerbated this burden. Health inequities have shown improvement between 1990 and 2021. Projections for the next 15 years suggest rising global age-standardized DALYs and death rates of IHD attributable to high BMI, while those attributable to low PA may decrease. CONCLUSIONS: Since 1990, the global and regional impact of IHD attributable to high BMI and low PA remains significant, with disparities by gender, age, region and SDI. Countries should implement effective measures to control BMI and promote PA to reduce the IHD burden.