Analysis and comparison of the trends in burden of ischemic heart disease in China and worldwide from 1990 to 2021

Abstract

Objectives This study aims to elucidate the trends in the burden of ischemic heart disease (IHD) in China from 1990 to 2021, stratified by gender and age. It encompasses a comprehensive analysis of incidence, prevalence, mortality, and disability-adjusted life years (DALYs), including age-standardized rates, while also providing a comparative perspective against global data. Methods Utilizing open data from the Global Burden of Disease (GBD) 2021 database, this study analyzed the characteristics of IHD burden in China and globally, focusing on changes in incidence, prevalence, mortality, and DALYs. Joinpoint regression analysis was employed to calculate the annual average percentage change (AAPC) and the corresponding 95% confidence interval (95% CI), facilitating a comparison of IHD burden differences between China and the global context across dimensions of gender, age, and time. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) of IHD in China increased from 315.31/100,000 to 365.67/100,000, while the global ASIR decreased from 419.54/100,000 to 372.90/100,000. The age-standardized prevalence rate (ASPR) in China rose from 2526.44/100,000 to 3042.35/100,000, whereas the global ASPR experienced a modest increase from 2904.72/100,000 to 2946.38/100,000. In terms of mortality, China's age-standardized mortality rate (ASMR) climbed from 94.14/100,000 to 110.91/100,000, in contrast to the global ASMR, which declined from 158.90/100,000 to 108.73/100,000. Similarly, the age-standardized disability-adjusted life years (ASDR) rate in China rose from 1771.14/100,000 to 1856.51/100,000, while globally, the ASDR fell from 3107.61/100,000 to 2212.16/100,000. The AAPC for IHD burden in China was 0.50% for ASIR, 0.60% for ASPR, 0.49% for ASMR, and 0.11% for ASDR, compared to global changes of -0.38%, 0.03%, -1.20%, and − 1.08%, respectively. Age and gender were found to significantly influence IHD burden, with the rates of incidence, prevalence, mortality, and DALYs generally increasing with age. Males bear a higher burden at younger ages, while the disease burden becomes more pronounced in females in older age groups. Conclusion From 1990 to 2021, the age-standardized burden of IHD in China increased significantly, contrasting sharply with the global trends of declining ASIR, ASMR, and ASDR. Moreover, The burden of IHD increases markedly with age, with males experiencing a heavier burden at younger ages, whereas females surpass males in older age groups. These gender and age differences highlight the need for early interventions targeting high-risk behaviors in males, alongside focused cardiovascular health management in elderly females. More precise prevention and control strategies are essential to effectively reduce the overall burden of IHD.