Burden of Ischemic Heart Disease in Central Asia from 1990 to 2021: A Systematic Analysis of the Global Burden of Disease Study 2021

Ischemic heart disease (IHD) remains a leading cause of death globally. This study aims to analyze the burden of IHD in Central Asia and in individual countries of the region from 1990 to 2021, through a comparison of trends in incidence, prevalence, mortality, and disability-adjusted life years. Using data from the Global Burden of Disease (GBD) 2021 study, we extracted annual estimates for the Central Asian region, Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Turkmenistan, Georgia, Armenia, Azerbaijan, and Mongolia. Metrics were reported as age-standardized rates per 100,000 population. Temporal trends were quantified using Average Annual Percent Change based on joinpoint regression models. A stratification by sex and age groups was done. Central Asia consistently maintained a higher IHD burden than the global average. While global age-standardized incidence rates per 100,000 population fell, Central Asia's rates per 100,000 population rose from 641.97 in 1990 to 801.56 in 2021. Age-standardized death rates per 100,000 population in the region peaked in the mid-1990s following the dissolution of the Soviet Union but decreased overall from 320.47 in 1990 to 265.51 in 2021. However, this remains significantly higher than the 2021 global rate per 100,000 population of 108.73. Uzbekistan exhibited the highest growth in prevalence and incidence rates per 100,000 population, while Georgia demonstrated the largest reduction in DALYs rates per 100,000 population. Men demonstrated a higher burden across most metrics, although the sex gap narrowed in older populations. Central Asia faces rising incidence rates of IHD and burden levels that far exceed global averages. The significant heterogeneity among countries suggests that region-wide generalizations are insufficient and highlights the critical need for targeted, country-specific prevention programs and health system interventions.