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

Ischemic heart disease (IHD) is a major barrier to sustainable human development and is associated with various modifiable risk factors. The aim of this study was to estimate the IHD burden attributable to 18 risk factors in Nanjing adults from eastern China between 2011 to 2017.

Data were collected from the Global Burden of Disease Study 2017. We conducted a comparative risk assessment analysis to estimate the IHD mortality and disability-adjusted life years (DALYs) attributable to one environmental, three behavioral, four metabolic, and 11 dietary risk factors in 2011 and 2017. The average exposure distributions were obtained from a systematic search of multiple databases. The means and 95% uncertainty intervals (UIs) were calculated and reported for IHD deaths, DALYs, and attributable to risk from 2011 and 2017.

The total IHD deaths in all ages increased between 2011 and 2017 in Nanjing, from 1747 (95%UI 1123–2371) to 2432 (95%UI 1839–3025) in men and 1866 (95%UI 1282–2450) to 2267 (95%UI 1702–2832) in women. IHD deaths accounted for 11.5% of all deaths in 2017, ranking only next to stroke (21.9%). Conversely, the age-standardized death rate of IHD decreased from 95.35 (95% UI 91.29–99.41) to 75.94 (95%UI 72.59–79.30) per 100,000 persons in men and from 79.85 (95%UI 76.11–83.59) to 56.10 (95%UI 53.26–58.94) per 100,000 persons in women. The four leading IHD risk factors for both mortality and DALY rates in 2017 were high systolic BP, high LDL-C, diet high in sodium, and diet low in fruits.

Population growth and aging led to a steady increase in IHD burden from 2011 to 2017. Dietary, behavioral, metabolic, and environmental risk factors account for most of the IHD burden, highlighting many opportunities for prevention.