Abstract 4361985: The Hypertensive Heart: Mapping Global IHD Burden and Projections to 2050

Abstract

Background: Hypertension is a key modifiable risk factor for ischemic heart disease (IHD), contributing significantly to global cardiovascular mortality. Understanding trends in IHD burden attributable to hypertension is essential to inform global prevention strategies. Aim: To examine global, regional, and national trends in IHD burden attributable to hypertension from 1980 to 2021 and forecast its trajectory to 2050 using GBD 2021 data. Methods: We analyzed age-standardized death rates (ASDR), years of life lost (YLL), and disability-adjusted life years (DALYs) from 1980 to 2021 across 204 countries. Joinpoint regression was used to calculate average annual percentage changes (AAPC). Forecasting to 2050 employed ARIMA and Poisson models. Results: Globally, the ASDR in 1990 was 85.74 (95% CI: 68.85–99.44), which declined to 56.73 (95% CI: 45.78–66.69) by 2021. From 1991 to 2021, the AAPC of YLL was -1.31 (95% CI: -1.50 to -1.11), while the AAPC for DALY was -1.14 (95% CI: -1.31 to -0.98). Regionally, Europe recorded the highest ASDR at 97.36 (95% CI: 80.24–112.24), followed by Africa at 77.93 (95% CI: 62.94–91.39). Asia and the Americas showed comparatively lower rates. The states with the highest ASDRs were Mississippi (78.88), Oklahoma (78.69), and West Virginia (78.21). By Socio-Demographic Index (SDI), the Middle SDI group had the highest average ASDR at 97.49 (95% CI: 50.27–74.15), while the High SDI group had the lowest at 53.34 (95% CI: 42.30–62.52). Forecasts project a global decline in ASDR, reaching 29.78 (95%CI:20.98–38.58) by 2050, with reductions expected across all continents. Conclusion: Global IHD mortality attributable to hypertension has declined since 1990 and is projected to continue declining by 2050. However, marked regional and socio-demographic disparities persist, highlighting the need for targeted prevention and control strategies.