Ischemic heart disease burden declines in rate but rises in number

Current Global Burden of Ischemic Heart Disease
IHD has consistently been the leading cause of cardiovascular death worldwide. According to GBD 2021 data, the global prevalent cases of IHD reached approximately 254 million in 2021, with about 9 million deaths. Compared to 1990, when there were 112 million prevalent cases, this represents a 127% increase. Although age-standardized rates for incidence and prevalence show a downward trend, the absolute burden—including the number of incident cases, prevalent cases, deaths, and disability-adjusted life years (DALYs)—continues to rise due to the expanding population base and the increasing number of older adults.

Sex- and Age-Stratified Analysis
The study specifically highlights significant differences in IHD burden trajectories between high-income and low- and middle-income regions. Some high-income countries have experienced a rapid decline in age-standardized incidence and mortality rates. In contrast, low- and middle-income countries face a faster-growing burden, hindered by lagging healthcare resources and control of risk factors. Regarding age and sex, the IHD burden shows no significant sex difference in populations under 40 years old. However, a marked disparity emerges after age 40, with the burden (incidence, mortality, etc.) becoming progressively higher in males than in females, reaching its maximum in the 75+ age group. This study, was published online on March 11, 2026, in the Chinese Medical Journal.

Future Trends of IHD
This study employed a Bayesian age-period-cohort (BAPC) model to project the global age-standardized incidence rate and number of incident IHD cases through to 2030. The projections indicate that while the age-standardized incidence rate is expected to decline, the total number of incident cases will continue to rise. The BAPC projections for different age groups reveal that, compared to older age groups, the incidence rate in younger and middle-aged groups may show an upward trend during certain periods. This suggests a trend towards a younger age of onset for IHD, a development that warrants attention from health authorities worldwide.

This study demonstrates that although age-standardized rates for IHD incidence and mortality have declined, the absolute burden—measured by the numbers of incident cases, deaths, and DALYs—continues to rise. This is attributable to the growing global aging population, which means a larger number of older individuals are bearing the disease burden. Furthermore, there is a trend towards IHD affecting younger populations, and males should pay particular attention to the prevention of cardiovascular diseases like IHD. From an economic perspective, the decline in age-standardized rates is more pronounced in high-income regions compared to low- and middle-income areas, underscoring that well-established medical facilities and sufficient healthcare resources are effective in preventing IHD and its associated burden. In the future, China's health authorities should focus more on cardiovascular disease situations in remote areas and formulate more comprehensive policies and regulations. This research provides crucial theoretical support for exploring cardiovascular disease prevention and treatment strategies tailored to China's national conditions and for achieving the goals of "Healthy China 2030."

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Reference
DOI: 10.1097/CM9.0000000000004006

About Juying Qian, Shengyu Jing, and Ao Chen from Fudan University, China
Corresponding author

Juying Qian, M.D., Ph.D., FESC, FACC, Vice-President of Zhongshan Hospital Fudan University, Prof. of Medicine (Cardiology), co-Director of Department of Cardiology, Executive Director of National Clinical Research Center for Interventional Medicine.

Co-first authors

Shengyu Jing, Doctoral Candidate in Cardiology, Zhongshan Hospital Fudan University.

Ao Chen, Ph.D., Attending Physician, Department of Cardiology, Zhongshan Hospital Fudan University.

Funding information
This study was supported by the National Natural Science Foundation of China (Nos. 81900307, 82470338, and 82170338), Natural Science Foundation of Shanghai (No. 24ZR1410000), Open Research Fund of State Key Laboratory of Cardiovascular Diseases (No. 15), Shanghai Municipal Key Clinical Specialty (No. shslczdzk01701).