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Background <p>Ischemic heart disease (IHD) and hypertensive heart disease (HHD) are among the leading causes of mortality and disease burden worldwide. This study, based on the 2021 Global Burden of Disease (GBD) data, systematically evaluated the global disease burden and risk factors of IHD and HHD from 1990 to 2021, and projected their trends through 2050, aiming to provide the latest evidence for the global prevention and control of cardiovascular diseases.</p> Methods <p>We extracted the age-standardized rates (ASR) of prevalence, mortality, and disability-adjusted life years (DALYs), as well as the estimated annual percentage change (EAPC) for IHD and HHD from the GBD 2021 database. Data were stratified by sex, age group, 21 global regions, and quintiles of the sociodemographic index (SDI) to elucidate temporal trends in disease burden and risk factors.</p> Results <p>From 1990 to 2021, global deaths due to IHD increased from 5.367&#xa0;million (95% uncertainty intervals [UI]: 5.076–5.562) to 8.992&#xa0;million(95% UI, 8.264–9.531), and deaths due to HHD rose from 714,000 (95% UI: 578,000–795,000) to 1.332&#xa0;million (95% UI: 1.121–1.469); however, the age-standardized mortality rate(ASMR) for both conditions declined (IHD EAPC = -1.30%, HHD EAPC = -0.68%). Significant regional disparities were evident, with East Asia experiencing a sharp increase in IHD standardized prevalence, and Sub-Saharan Africa exhibiting high HHD mortality rates. The disease burden displayed marked heterogeneity by age and sex: IHD predominantly affected elderly males, whereas HHD incidence increased exponentially after age 45, with a higher burden observed in older females compared to males. SDI was inversely correlated with DALYs rates for both diseases, although some high-SDI regions still reported elevated HHD burdens. Risk factor analysis identified elevated systolic blood pressure as the primary driver, with high body mass index (BMI) and high sodium diets as common secondary contributors. Projections indicate that by 2050, ASMR for both diseases will continue to decline, but prevalence rates are expected to rise driven by population aging.</p> Conclusion <p>IHD and HHD represent significant and escalating global cardiovascular health burdens. Population aging has driven an increase in the absolute burden upward, while uneven regional progress in prevention has exacerbated the situation. This underscores the necessity of developing targeted strategies in risk management, early screening, and context-specific interventions, especially for vulnerable groups such as those in low to middle SDI regions and elderly women. Addressing modifiable risk factors and improving long-term disease burden forecasting are critical to slowing the growth of prevalence and optimizing healthcare resource allocation. Coordinated public health policies and integrated clinical management are essential to mitigate the global impact of IHD and HHD and improving patient outcomes.</p>

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Systematic analysis of global ischemic heart disease and hypertensive heart disease burden, 1990–2021: projections to 2050

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月5日

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  • Shanshan Li,
  • Yanwen Liu,
  • Chenggang Liu

摘要

Background

Ischemic heart disease (IHD) and hypertensive heart disease (HHD) are among the leading causes of mortality and disease burden worldwide. This study, based on the 2021 Global Burden of Disease (GBD) data, systematically evaluated the global disease burden and risk factors of IHD and HHD from 1990 to 2021, and projected their trends through 2050, aiming to provide the latest evidence for the global prevention and control of cardiovascular diseases.

Methods

We extracted the age-standardized rates (ASR) of prevalence, mortality, and disability-adjusted life years (DALYs), as well as the estimated annual percentage change (EAPC) for IHD and HHD from the GBD 2021 database. Data were stratified by sex, age group, 21 global regions, and quintiles of the sociodemographic index (SDI) to elucidate temporal trends in disease burden and risk factors.

Results

From 1990 to 2021, global deaths due to IHD increased from 5.367 million (95% uncertainty intervals [UI]: 5.076–5.562) to 8.992 million(95% UI, 8.264–9.531), and deaths due to HHD rose from 714,000 (95% UI: 578,000–795,000) to 1.332 million (95% UI: 1.121–1.469); however, the age-standardized mortality rate(ASMR) for both conditions declined (IHD EAPC = -1.30%, HHD EAPC = -0.68%). Significant regional disparities were evident, with East Asia experiencing a sharp increase in IHD standardized prevalence, and Sub-Saharan Africa exhibiting high HHD mortality rates. The disease burden displayed marked heterogeneity by age and sex: IHD predominantly affected elderly males, whereas HHD incidence increased exponentially after age 45, with a higher burden observed in older females compared to males. SDI was inversely correlated with DALYs rates for both diseases, although some high-SDI regions still reported elevated HHD burdens. Risk factor analysis identified elevated systolic blood pressure as the primary driver, with high body mass index (BMI) and high sodium diets as common secondary contributors. Projections indicate that by 2050, ASMR for both diseases will continue to decline, but prevalence rates are expected to rise driven by population aging.

Conclusion

IHD and HHD represent significant and escalating global cardiovascular health burdens. Population aging has driven an increase in the absolute burden upward, while uneven regional progress in prevention has exacerbated the situation. This underscores the necessity of developing targeted strategies in risk management, early screening, and context-specific interventions, especially for vulnerable groups such as those in low to middle SDI regions and elderly women. Addressing modifiable risk factors and improving long-term disease burden forecasting are critical to slowing the growth of prevalence and optimizing healthcare resource allocation. Coordinated public health policies and integrated clinical management are essential to mitigate the global impact of IHD and HHD and improving patient outcomes.