Ischemic heart disease attributable to high body mass index in pakistan versus worldwide: an analysis of the global burden of disease study 2021

Abstract Introduction Ischemic Heart Disease (IHD) is one of the major causes of cardiovascular-related deaths worldwide. High Body Mass Index (HBMI) is an important risk factor for IHD. Previous studies have evaluated the IHD burden globally, however, very limited literature is available on its burden in Pakistan compared to the rest of the world. Purpose To investigate the effect of HMBI on the global burden of IHD in Pakistan versus globally from 1990 to 2021. Methods Age-standardized death rates (ASMR), years of lost life (YLLs), and disability-adjusted life years (DALYs) were calculated from the Global Burden of Disease (GBD) Database 2021. Joinpoint Regression was used to calculate annual percentage changes (APCs) in ASMR, DALYs and YLLs with 95 % uncertainty intervals and identify significant trends over time. Statistical significance was set at a p-value 0.05. Results Globally, the ASMR was 13.77 in 1999, which dropped to 11.71 in 2021 with a significant AAPC of -0.53 (95% UI: -0.72 to -0.32, p 0.000001, Figure 1), whereas the ASMR in Pakistan tripled from 5.99 in 1999 to 15.45 in 2021 (AAPC: 3.11; 95% CI: 2.94 to 3.27; p 0.000001, Figure 2). Similarly, DALYs also showed a decreasing trend globally from 300.77 in 1990 to 277.65 in 2021 (APC: -0.26; 95% UI: -0.44 to -0.06; p = 0.007) while Pakistan experienced over a twofold increase in DALYs throughout the observed study period (APC: 3.04; 95% UI: 2.85 to 3.23; p 0.000001). In 1990, the Global YLLs were reported to be 296.29, which exhibited a decline to 271.63 in 2021 (APC: -0.28; 95% UI: -0.47 to -0.09; p = 0.004 ). On the contrary, the observed YLLs in 1999 were 166.48 in Pakistan, which displayed a substantial increase to 421.96 in 2021 (APC: 3.05; 95% UI: 2.86 to 3.24; p 0.000001). Conclusions Our study revealed a sharp rise in the HBMI-associated IHD burden in Pakistan over the past three decades. These trends contrast with the global trends which are on the decrease. These high rates necessitate better public health policies, clinical strategies, early detection, and equitable treatment to ensure sustained progress in combating IHD.