Temporal Trends in Ischemic Heart Disease Mortality in 21 World Regions, 1980-2010: The Global Burden of Disease 2010 Study

Abstract

Background—Ischemic Heart Disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Risk Factors and Injuries (GBD) 2010 Study estimated global and regional IHD mortality from 1980 to 2010.

Methods and Results—Sources for IHD mortality estimates were country-level surveillance, verbal autopsy, and vital registration data. Regional income, metabolic and nutritional risk factor and other covariates were estimated from surveys and a systematic review. An estimation and validation process led to an ensemble model of IHD mortality for 21 world regions. Globally, age-standardized IHD mortality declined since the 1980's, and high-income regions (especially Australasia, Western Europe, and North America) experienced the most remarkable declines. Age-standardized IHD mortality increased in former Soviet Union countries and South Asia in 1990's and attenuated after 2000. In 2010, Eastern Europe and Central Asia had the highest age-standardized IHD mortality rates. More IHD deaths occurred in South Asia in 2010 than in any other region. On average, IHD deaths in South Asia, North Africa and Middle East, and Sub-Saharan Africa occurred at younger ages compared with most other regions.

Conclusions—In most world regions, particularly in high-income regions, age-standardized IHD mortality rates declined significantly since 1980. High age-standardized IHD mortality in Eastern Europe, Central Asia, and South Asia point to the need to prevent and control established risk factors in those regions and research unique behavioral and environmental determinants of higher IHD mortality.