Global Burden of Ischemic Heart Disease and Attributable Risk Factors, 1990–2017: A Secondary Analysis Based on the Global Burden of Disease Study 2017

Figures & data

Table 1 The Incidence Cases and Age-Standardized Incidence of Ischemic Heart Disease in 1990 and 2017, and Its Temporal Trends from 1990 to 2017

Types	1990		2017		1990–2017
	Incidence Cases (No.×10^3(95% UI))	ASIR per 100,000 (No. (95% UI))	Incidence Cases (No.×10^3(95% UI))	ASIR per 100,000 (No. (95% UI))	EAPC (No. (95% UI))
Overall	7005.6(6372.7, 7667.7)	186.7(171.4, 203.2)	10,636.5(9573.2, 11,794.5)	135.6(122.2, 150.4)	−27.4(−28.97, −25.78)
Sex
Male	4033.7(3663.6, 4423.6)	239.1(219.8, 258.9)	6125.9(5523.0, 6773.5)	169.8(154.0, 187.3)	−28.99(−30.48, −27.44)
Female	2971.8(2699.5, 3262.5)	143.6(131.4, 157.6)	4510.6(4036.5, 5029.1)	105.4(94.3, 117.4)	−26.62(−28.46, −24.72)
Social-demographic index
High SDI	2864.2(2629.9, 3114.4)	222.7(204.3, 241.9)	3437.3(3124.1, 3783.3)	154.2(139.3, 170)	−30.77(−32.29, −29.19)
High-middle SDI	1807.2(1636.3, 1979.4)	211.7(193.5, 231.0)	2530.3(2257.3, 2826.5)	145.5(130.4, 162.3)	−31.27(−33.35, −29.18)
Middle SDI	1032.7(923.9, 1150.7)	123(111.7, 135.5)	2176(1932.5, 2435.2)	104.6(93.5, 117.2)	−14.97(−16.95, −13.07)
Low-middle SDI	880.7(801.5, 965.3)	174.3(160.4, 188.8)	1635.4(1476.5, 1802.9)	148.1(134.9, 162.2)	−15.08(−16.82, −13.45)
Low SDI	404.7(361.0, 452.1)	136(122.7, 150.4)	824.7(734.8, 922.2)	126.4(113.4, 140.4)	−7.05(−8.66, −5.42)
Region
Central Asia	120.8(112.3, 130.3)	282(263.0, 303.4)	162.8(150.3, 175.3)	263.6(246.1, 282.2)	−6.53(−8.63, −4.33)
Central Europe	469.9(442.4, 497.9)	334.3(317.0, 353.2)	422.5(387.9, 460.3)	195.7(180.1, 212.6)	−41.47(−43.99, −38.47)
Eastern Europe	876.6(790.0, 967.0)	320.1(289.7, 351.9)	893.3(790.5, 1002.8)	257.3(229.0, 289.0)	−19.62(−22.42, −17.02)
Australasia	62.7(57, 68.5)	265.7(242.5, 289.7)	77.1(68.9, 87.1)	158.8(141.2, 178.3)	−40.23(−43.95, −36.32)
High-income Asia Pacific	248.9(217.4, 282.9)	124.1(109.1, 140.3)	438.4(381.5, 505.1)	100(87.3, 114)	−19.42(−21.36, −17.62)
High-income North America	928.3(829.9, 1030.1)	259.5(231.5, 289.4)	1137(1044.2, 1240.8)	189.3(173.5, 206.6)	−27.08(−30.54, −23.62)
Southern Latin America	92.7(85.4, 101.1)	205.8(190.2, 223.3)	114.9(102.4, 127.6)	139.7(124.5, 155.4)	−32.13(−35.71, −28.7)
Western Europe	1328.7(1236.9, 1428.8)	221.6(206.1, 237.8)	1480.4(1339.4, 1637.5)	158.5(142.7, 175.8)	−28.46(−31.61, −25.39)
Andean Latin America	19.4(17.2, 21.9)	99(87.6, 111.3)	42.4(36.8, 48.5)	78.8(68.5, 90.1)	−20.41(−23.86, −17.21)
Caribbean	42.7(38.3, 47.4)	167.9(151.5, 185.3)	61.2(53.8, 68.9)	120(105.7, 135.6)	−28.52(−31.72, −25.74)
Central Latin America	98.9(87.8, 110.9)	121.8(108.4, 136.6)	220.6(193.5, 249.7)	96.8(84.9, 109.8)	−20.52(−22.27, −18.75)
Tropical Latin America	96.6(85.2, 108.7)	111.2(99.2, 124.3)	181.3(157.7, 205.9)	78.9(68.9, 89.4)	−29.06(−31.31, −26.7)
North Africa and Middle East	581.6(538.6, 627)	358.9(334.4, 384.4)	1128.1(1023.8, 1236.8)	273.8(250.4, 297.2)	−23.7(−25.9, −21.58)
South Asia	783.2(703.4, 867.5)	149.4(135.7, 163.9)	1645.9(1473.3, 1832.2)	132.2(119.3, 146.2)	−11.52(−13.43, −9.52)
East Asia	734.5(646.7, 827)	90.5(80.6, 100.9)	1661.5(1465.3, 1878)	86.1(76.1, 97.2)	−4.85(−7.09, −2.17)
Oceania	3.3(2.8, 3.7)	120.2(105.3, 136.7)	7.3(6.3, 8.4)	119.5(104.4, 136.1)	−0.62(−4.02, 2.96)
Southeast Asia	275.9(246.9, 306.8)	123.3(112.2, 135.5)	525(465.8, 585.2)	97.4(87.4, 108.5)	−21.03(−23.06, −19.08)
Central Sub-Saharan Africa	29.9(26.5, 33.6)	151.3(135.8, 167.6)	55.7(48.8, 63.2)	125.5(112.2, 140.6)	−17.04(−20.3, −13.63)
Eastern Sub-Saharan Africa	83(72.4, 94.4)	120.5(106.4, 135.8)	153.1(132.7, 174.7)	104.2(90.9, 118.7)	−13.53(−15.34, −11.78)
Southern Sub-Saharan Africa	33.4(28.9, 38)	123.8(107.7, 141.9)	60.4(52.1, 68.9)	113.9(99.2, 130.2)	−8.03(−9.31, −6.67)
Western Sub-Saharan Africa	94.5(83.7, 106.1)	117.6(105.8, 130.8)	167.8(147.6, 189.8)	102(90.1, 114.5)	−13.22(−15.79, −10.6)

Abbreviations: ASIR, age-standardized incidence rate; UI, uncertain interval; EAPC, estimated annual percentage change; SDI, Socio-demographic Index.

Figure 1 The age-standardized incidence(a), death(b), and DALY(c) rates of global ischemic heart disease for both sexes, 1990–2017.

Table 2 Joinpoint Analysis for IHD-Related Age-Standardized Incidence, Mortality, and DALY Rate in Different SDI Quintiles, 1990–2017

Types	AAPC	Trend1		Trend2		Trend3		Trend4
		Year	EAPC	Year	EAPC	Year	EAPC	Year	EAPC
Incidence
Global	−1.2*	1990–1994	0.2*	1994–2000	−0.5*	2000–2006	−1.4*	2006–2017	−1.9*
High SDI	−1.3*	1990–2000	−0.5*	2000–2005	−2.4*	2005–2009	−2.1*	2009–2017	−1.3*
High-middle SDI	−1.4*	1990–1995	0.8*	1995–2004	−0.9*	2004–2012	−2.1*	2012–2017	−3.2*
Middle SDI	−0.6*	1990–1994	1.2*	1994–2005	0.0*	2005–2012	−1.5*	2012–2017	−2.1*
Low-middle SDI	−0.6*	1990–1995	0.9*	1995–2005	−0.2*	2005–2012	−1.5*	2012–2017	−1.8*
Low SDI	−0.3*	1990–1993	1.2*	1993–2006	0.2*	2006–2017	−1.2*
Mortality
Global	−1.3*	1990–1994	−0.5	1994–1997	−2.3*	1997–2008	−1.5*	2008–2017	−1.1*
High SDI	−3.3*	1990–1999	−3.3*	1999–2011	−4.0*	2011–2017	−1.6*
High-middle SDI	−1.2*	1990–1994	2.7*	1994–1998	−2.9*	1998–2003	0.0	2003–2017	−2.2*
Middle SDI	−0.3*	1990–1999	−0.9*	1999–2007	0.1	2007–2011	0.9*	2011–2017	−0.6*
Low-middle SDI	−0.3*	1990–1998	−0.1	1998–2005	−0.8*	2005–2012	0.2	2012–2017	−0.8*
Low SDI	−0.3*	1990–2000	−0.8*	2000–2005	−0.1	2005–2009	1.1*	2009–2017	−0.4*
DALY
Global	−1.2*	1990–1994	−0.1	1994–1997	−2.1*	1997–2009	−1.4*	2009–2017	−1.0*
High SDI	−3.3*	1990–1995	−3.4*	1995–2010	−3.9*	2010–2014	−2.7*	2014–2017	−0.6
High-middle SDI	−1.3*	1990–1994	3.7*	1994–1998	−3.3*	1998–2003	0.2	2003–2017	−2.7*
Middle SDI	−0.4*	1990–1999	−0.7*	1999–2007	−0.4*	2007–2011	0.7*	2011–2017	−0.6*
Low-middle SDI	−0.4*	1990–1998	−0.0	1998–2005	−1.0*	2005–2012	0.2	2012–2017	−1.0*
Low SDI	−0.3*	1990–2005	−0.6*	2005–2008	1.3	2008–2011	0.1	2011–2017	−0.6*

Note: *Significantly different from zero (P<0.05).

Abbreviations: IHD, ischemic heart disease; DALY, disability-adjusted life-years; AAPC, average annual percentage change; EAPC, estimated annual percentage change; SDI, Socio-demographic Index.

Figure 2 Relationship between the age-standardized incidence (A), death (B), and DALY (C) rates for IHD and social-demographic index over time. Each colored line represents a time trend of the relationship for the specified region. Each point represents a specific year for that region. The black line represents the overall global trend for the age-standardized rate of IHD concerning to SDI.

Figure 3 Ranking the risk factors for DALYs, by global and region, 2017.