ArticleCardiology research and practice2026
Global Burden of Ischemic Heart Disease and Ischemic Stroke, 1990-2023: Spatial Heterogeneity, SDI Inequalities, Pandemic-Era Inflections, and Scenario Forecasts to 2035 Using GBD 2023.
Article in Cardiology research and practice, 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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10 authors.
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Abstract
Background: Ischemic heart disease (IHD) and ischemic stroke (IS) remain leading causes of death and disability, with substantial geographic and sociodemographic inequalities. We assessed long-term trends, sociodemographic index (SDI) disparities, COVID-19-period inflections, risk-factor profiles, and scenario forecasts using Global Burden of Disease (GBD) 2023 estimates. Methods: Using GBD 2023 data (1990-2023), we analyzed age-standardized incidence (ASIR), death (ASDR), and DALY rates (ASDALY) globally and across SDI quintiles. COVID-19 impacts were evaluated using segmented log-linear models (2010-2019 vs. 2020-2023), estimating the average annual percent change (AAPC) and counterfactual deviations extrapolating pre-COVID trends. Risk attribution used the GBD comparative risk assessment framework. ARIMA-based forecasts projected global ASDR/ASDALY to 2035, with S1 fitted to 2010-2019 and S2 to 2010-2023; 1990-start forecasts were assessed as sensitivity analyses. Results: In 2023, ASDRs varied widely across countries (IHD 24.9-441.0; IS 6.0-182.5 per 100,000). From 1990 to 2023, global ASDR declined for both diseases (IHD -38.2%; IS -53.1%), with an IHD SDI reversal (high SDI -52.8% vs. low SDI +13.4%). During 2020-2023, IHD mortality plateaued (AAPC 0.06%/year), whereas IS continued to decline but slowed (AAPC -1.48%/year). Forecasts to 2035 indicated a higher projected burden under S2 than S1. Conclusions: Progress in IHD and IS burden has been uneven, with widening SDI disparities and pandemic-era attenuation, underscoring the need for equitable and resilient prevention and care.
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