Jaiswal Vikash, Van den Eynde Jef, Mashkoor Yusra, Huang Helen, Garimella Vamsi, Khadka Sulochana, Kumar Tushar, Jaiswal Akash, Aronow Wilbert, Banach Maciej, Fonarow Gregg C
Department of Cardiovascular Research, Larkin Community Hospital, South Miami, Florida, USA.
The Blalock Taussig Thomas Pediatric and Congenital Heart Center, Department of Pediatrics, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Department of Cardiovascular Sciences, KU Leuven & Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium.
JACC Adv. 2025 Jun 19;4(7):101904. doi: 10.1016/j.jacadv.2025.101904.
Ischemic heart disease (IHD) remains one of the leading causes of morbidity and mortality across the globe, and disparities exist based on sex and geographic region.
This study investigates global trends in IHD mortality and examines disparities based on sex and geographic regions.
IHD mortality data from 105 countries were obtained from the World Health Organization Mortality Database. Crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) per 100,000 individuals were calculated, with average annual percentage change (AAPC) analyzed using joinpoint regression. Regional and sex-specific trends were assessed using stratified analyses of CMR and ASMR.
Globally, CMR declined from 138 per 100,000 (95% CI: 131-145) in 2000 to 106 per 100,000 (95% CI: 102-114) in 2019 (AAPC: -1.79, 95% CI: -1.93 to -1.66). Similarly, ASMR declined from 104 per 100,000 (95% CI: 99-108) to 65.5 (95% CI: 62-69) in 2019 per 100,000 (AAPC: -2.16, 95% CI: -2.13 to -2.20). Regionally, CMRs decreased in Oceania, Europe, and North America, while they rose in Asia, Africa, and Central and South America. ASMRs declined worldwide except in Africa (AAPC: 1.33, 95% CI: 1.30-1.36). Males showed higher mortality than females, but both sexes demonstrated decreasing trends, with males having a steeper decline. In age groups across all regions, Africa showed an upward trend, while other regions demonstrated declines.
While global IHD mortality has declined from 2000 to 2019, disparities by geographic region and sex persist. Implementing targeted health awareness programs and collaborative global health efforts are crucial for addressing these inequalities.
缺血性心脏病（IHD）仍然是全球发病和死亡的主要原因之一，并且存在基于性别和地理区域的差异。
本研究调查全球缺血性心脏病死亡率趋势，并研究基于性别和地理区域的差异。
从世界卫生组织死亡率数据库获取105个国家的缺血性心脏病死亡率数据。计算每10万人的粗死亡率（CMR）和年龄标准化死亡率（ASMR），并使用Joinpoint回归分析平均年度百分比变化（AAPC）。通过对CMR和ASMR的分层分析评估区域和性别特异性趋势。
全球范围内，CMR从2000年的每10万人138例（95%CI：131-145）下降到2019年的每10万人106例（95%CI：102-114）（AAPC：-1.79，95%CI：-1.93至-1.66）。同样，ASMR从2000年的每10万人104例（95%CI：99-108）下降到2019年的每10万人65.5例（95%CI：62-69）（AAPC：-2.16，95%CI：-2.13至-2.20）。在区域方面，大洋洲、欧洲和北美的CMR下降，而亚洲、非洲以及中美洲和南美洲的CMR上升。除非洲外，全球ASMR均呈下降趋势（AAPC：1.33，95%CI：1.30-1.36）。男性死亡率高于女性，但两性均呈下降趋势，男性下降幅度更大。在所有区域的年龄组中，非洲呈上升趋势，而其他区域呈下降趋势。
虽然2000年至2019年全球缺血性心脏病死亡率有所下降，但地理区域和性别差异依然存在。实施有针对性的健康意识计划和全球合作的卫生工作对于解决这些不平等问题至关重要。
