# Global burden and trend of ischemic heart disease and its attributable risk factors among women of childbearing age from 1990 to 2021

## TL;DR

This study shows that ischemic heart disease is increasing among women of childbearing age globally, with significant regional differences and growing risks like high BMI and blood pressure.

## Contribution

The study provides a global assessment of ischemic heart disease trends and risk factors among women of childbearing age from 1990 to 2021.

## Key findings

- IHD incidence increased slightly, while mortality and DALYs decreased globally from 1990 to 2021.
- High BMI and high blood pressure are increasingly significant risk factors for IHD in higher-SDI regions.
- Low- and middle-SDI regions show declining IHD rates but rising absolute numbers of deaths and DALYs.

## Abstract

To assess the burden and trends of ischemic heart disease (IHD) and the risk-attributable fractions in women of childbearing age (WCBA) from 1990 to 2021 across 204 countries and territories.

Data on the number and crude rates of incidence, mortality, disability-adjusted life years (DALYs), and the proportion attributable to risk factors were obtained from the Global Burden of Disease Study 2021. Temporal trends were assessed by calculating the estimated annual percentage change in age-standardized rate.

In 2021, there were 1,349,518 [95% uncertainty interval (UI), 924,620–1,849,024] new cases of IHD among WCBA, resulting in 172,204 (95% UI, 157,564–188,669) deaths and 8,712,835 (95% UI, 7,995,218–9,531,167) DALYs globally. From 1990 to 2021, the age-standardized incidence rate increased by a slight annual change of 0.4%, while the age-standardized mortality and DALY rates declined by 1.04% and 1.02% annually, respectively. Regional analysis revealed the highest IHD burden in North Africa and the Middle East, while Oceania reported the highest mortality-to-incidence ratio. While the age-standardized mortality and DALYs rates of IHD have shown a declining trend in low- and middle-SDI regions, the absolute numbers of deaths and DALYs have risen substantially. Attributable risks, including poor diet, tobacco use, high body mass index, and high blood pressure, were major contributors to IHD-related deaths and DALYs. Notably, the proportion of IHD attributable to high BMI and high blood pressure has increased, particularly in higher-SDI regions.

The burden of IHD among WCBA is rising globally, with significant regional disparities and increasing attributable risks, particularly in low- and middle-SDI regions. These findings highlight the urgent need for targeted, gender-responsive policies and preventive strategies that address modifiable risk factors, strengthen primary healthcare systems, and prioritize cardiovascular health across the life course.