Abstract Background Inflammatory Heart Disease (IHD) remains one of the leading causes of morbidity and mortality across the globe. In recent decades its management has evolved, but disparities still persist based on sex and geographic regions. Objective This study investigates global trends in IHD mortality and examines disparities based on sex and geographic regions. Methods IHD mortality data from 2000 to 2021 were retrieved from the World Health Organization Mortality Database. Crude (CMRs) and age-standardized mortality rates (ASMRs) per 100,000 individuals were calculated, with average annual percentage change (AAPC) analyzed using joinpoint regression. Results The analysis included 113 countries across six regions. Globally, there was a steady increase in CMR due to IHD, with 7.62 (CI: 7.29-7.97) in 2000 to 8.24 (CI: 7.80-8.67) in 2021 with an AAPC of 0.42 (CI: -1.04-1.88). However, there were fluctuations in ASMR with a generally declining trend from 6.48 (CI: 6.22 to 6.75) in 2000 to 4.51 (CI:4.27-4.73), with a sharp decline in 2020, and AAPC of -1.52 (CI: 1.35 to -4.15), signifying higher mortality rate in the elderly. Regionally CMR also increased in most of the countries, except the Americas. Africa and Asia showed the greatest rise in CMR (AAPC 0.30, CI:0.20-0.40 and 0.13, CI:0.08-0.17 respectively). In contrast, most region had declining ASMR except Africa and Asia (AAPC, Africa: 0.30, CI:0.06-0.53 and Asia: 0.05, CI:0.04-0.08). Males consistently showed higher CMR than females (AAPC, Male: 0.38, CI: 0.36-0.38 and Female: 0.09, CI:0.08-0.11). Both sexes displayed a u pattern over the observation period, with initial decline and then gradual increase in CMR. However, ASMR showed a general decline regardless of sex (AAPC, Male: -0.08, , CI: -0.10 to -0.06, Female: -0.06, CI:-0.08 to -0.04). Moreover, older age group, particularly those above 85 years displayed higher mortality rate, with Europe and Asia showing the highest increase. On the other hand, North America displayed decreasing trend across most age groups. Conclusion This study reveals a global decline in age-standardized IHD mortality, though significant disparities remain by region and sex. Mortality rates are rising in Africa and Asia, while men consistently show higher rates than women. The elderly, particularly those over 85, face the highest mortality. These findings highlight the need for targeted, region-specific interventions and global health efforts to reduce IHD disparities.Figure 1
Jaiswal et al. (2025) studied this question.