Global burden of ischemic heart disease attributable to low physical activity in adults ≥40 years, 1990-2021 and projections to 2046: a GBD 2021 analysis.

OBJECTIVES

To analyze and predict the temporal and spatial trends of ischemic heart disease burden attributable to low physical activity in adults ≥40 years.

DESIGN

Cross-sectional time-trend analysis combined with Bayesian prediction modeling.

METHODS

Using Global Burden of Disease 2021 data, this study explored the burden of ischemic heart disease attributable to low physical activity across regions and countries from 1990 to 2021, analyzing its association with the sociodemographic index. The average annual percentage change of age-standardized mortality rate and age-standardized disability-adjusted life year rate was calculated to quantify the temporal trends, and the Bayesian Age-Period-Cohort model was used to predict the future burden to 2046.

RESULTS

In 2021, low physical activity-related ischemic heart disease caused 231,001 deaths and 3.83 million DALYs in adults ≥40 years. From 1990 to 2021, the average annual percentage change of age-standardized mortality rate and age-standardized disability-adjusted life year rate was -1.13 and -1.04, respectively. Females had a heavier burden but it decreased faster. Age-standardized mortality rate and age-standardized disability-adjusted life year rate showed an inverted U-shaped relationship with sociodemographic index. The projections show age-standardized rates declining and then increasing.

CONCLUSIONS

Globally, ischemic heart disease burden attributable to low physical activity remains high in adults ≥40 years, particularly among women, older adults, and low-middle sociodemographic index regions. These groups require targeted interventions. Although age-standardized disability-adjusted life year rate and age-standardized mortality rate have declined historically, future increases remain possible.