Temporal trends and breakpoints in age standardized DAYS rates for ischemic heart disease global and country level analysis from 1990 to 2021

Abstract Background Ischaemic heart disease (IHD) is a major cause of death and morbidity globally, and it accounts for a high proportion of the worldwide disease burden. It is imperative to comprehend the temporal trends and breakpoints in age-standardized disability-adjusted life year (DALY) rates to analyze the impact of interventions and assign priority to regions in need of public health intervention. Methods The current study examines trends in age-standardized DALY rates for IHD at the global and country levels from 1990 to 2021 based on Global Burden of Disease (GBD) Study data. Joinpoint regression analysis was used to determine segmental breakpoints and compute Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) across regions. Results At the global level, two prominent trend segments were observed for DALY rates for IHD1990–1994: A stagnation period with little change (APC = +0.15%), and the trend was not statistically significant since the confidence interval (-0.53 to 0.84) contained zero.1994–2021: A significant and sustained decrease (APC = -1.27%, p 0.05), indicating the effect of enhanced cardiovascular care and preventive interventions. At the country level, the majority of regions exhibited a decreasing IHD burden, with the largest decreases seen in:Denmark (-2.28% AAPC)Israel (-5.80% AAPC)Norway (-5.28%AAPC) Nevertheless, certain areas continue to bear growing burdens, including Lesotho (+3.06% AAPC) Conclusion This analysis underscores significant global reductions in the burden of IHD over the past three decades, with breakpoints often occurring after 1994. Many countries, including Denmark, Israel, and Norway, have seen very substantial reductions; Lesotho remains one of the few that still continues an increasing trend. The findings therefore suggest targeted interventions are needed in the high-burden nations. These trends will help to inform future prevention strategies and health policies for further reductions in IHD-related morbidity and mortality around the world.guide future cardiovascular disease prevention strategies and health policies to further reduce IHD-related morbidity and mortality worldwide.Figure