Evidence mapPaperPMID 42504215Full record

ArticleHealth science reports2026

Ischemic Heart Disease in the Middle East and North Africa, 1990-2021: An Integrated Analysis of Temporal Trends, Country-Level Variation, SDI Patterns, and Risk Factors.

Nahid Karamzad, Saeid Safiri, Amir Ghaffari Jolfayi, Seyed Ehsan Mousavi, Fatemeh Amiri, Mohammad Rahmanian, Mark J M Sullman, Ali-Asghar Kolahi

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Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Nahid KaramzadSocial Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran.
Saeid SafiriAging Research Institute Tabriz University of Medical Sciences Tabriz Iran.ORCID https://orcid.org/0000-0001-7986-9072
Amir Ghaffari JolfayiCardiovascular Research Center, Rajaie Cardiovascular, Medical, and Research Center Iran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0002-9223-5565
Seyed Ehsan MousaviSocial Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran.ORCID https://orcid.org/0000-0003-4747-5639
Fatemeh AmiriSocial Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran.ORCID https://orcid.org/0000-0003-0668-0978
Mohammad RahmanianStudent Research Committee, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran.
Mark J M SullmanDepartment of Life and Health Sciences University of Nicosia Nicosia Cyprus.ORCID https://orcid.org/0000-0001-7920-6818
Ali-Asghar KolahiSocial Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0003-0178-3732

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Ischemic heart disease (IHD) remains a leading cause of mortality and disability worldwide. Using Global Burden of Disease (GBD) 2021 estimates, this study provides an integrated assessment of IHD burden across the Middle East and North Africa (MENA) region from 1990 to 2021, highlighting temporal trends, inter-country heterogeneity, sociodemographic index (SDI)-related patterns, and attributable risk factors by sex and age. Methods: We conducted a secondary analysis of GBD 2021 estimates for the 21 countries and territories in MENA. We assessed prevalence, deaths, and disability-adjusted life years (DALYs), reporting counts and age-standardized rates per 100,000 population with 95% uncertainty intervals (UIs). This framework allowed direct comparison of temporal change, cross-country variation, development-related gradients, and modifiable risk attribution within a single regional analysis. Results: In 2021, the age-standardized prevalence of IHD in MENA was 6404.8 per 100,000 (95% UI: 5872.0-7041.1), with an age-standardized mortality rate of 202.8 (95% UI: 180.6-223.7) and DALY rate of 4023.2 (95% UI: 3581.7-4507.5). Although age-standardized death and DALY rates declined from 1990 to 2021, the burden remained substantial and unevenly distributed. Kuwait had the highest age-standardized prevalence [7806.4 (95% UI: 7141.6-8556.3)] and Turkey the lowest [5365.9 (95% UI: 4895.5-5874.7)]. Saudi Arabia had the largest increase in age-standardized prevalence [17.1% (95% UI: 11.4-23.0)], whereas Turkey had the largest decrease [-11.9% (95% UI: -17.3 to -6.9)]. DALY rates increased progressively with age for both sexes, and IHD burden showed an inverse, non-linear relationship with SDI. The leading contributors to IHD DALYs were elevated systolic blood pressure [49.6%], elevated LDL cholesterol [39.6%], and exposure to ambient particulate matter pollution [28.2%]. Conclusion: Despite reductions in age-standardized mortality and DALY rates, IHD remains a major public health challenge in MENA, with substantial cross-country variation and a large contribution from modifiable risks. By integrating temporal trends, inter-country heterogeneity, SDI-related patterns, and attributable risk factors, this study provides novel evidence for prioritizing prevention efforts across the region. These findings support context-specific prevention strategies prioritizing hypertension control, lipid management, and improved access to cardiovascular prevention and treatment, alongside action to reduce air pollution exposure; implementation should be tailored to national risk profiles, disease trends, and health-system capacity.

Indexed as

heart diseasesMiddle Eastmyocardial ischaemiaNorth Africa

Identifiers

PMID42504215
PMCPMC13401702

What Socratic holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.