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

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.