Global Burden of Disease Study 2019 suggests that metabolic risk factors are the leading drivers of the burden of ischemic heart disease

Metabolic dysfunction is becoming a predominant risk for the development of many comorbidities. Ischemic heart disease (IHD) still imposes the highest disease burden among all cardiovascular diseases worldwide. However, the contributions of metabolic risk factors to IHD over time have not been fully characterized. Here, we analyzed the global disease burden of IHD and 15 associated general risk factors from 1990 to 2019 by applying the methodology framework of the Global Burden of Disease Study. We found that the global death cases due to IHD increased steadily during that time frame, while the mortality rate gradually declined. Notably, metabolic risk factors have become the leading driver of IHD, which also largely contributed to the majority of IHD-related deaths shifting from developed countries to developing countries. These findings suggest an urgent need to implement effective measures to control metabolic risk factors to prevent further increases in IHD-related deaths. [Display omitted] •Metabolic risks are the leading drivers of IHD globally•The IHD burden has shifted from higher SDI regions to lower ones•Uncontrolled metabolic risk led to unchanged IHD-related deaths in lower SDI regions•Well-controlled metabolic risk led to decreased IHD deaths in higher SDI regions Globally, ischemic heart disease (IHD) has the highest mortality rate of all forms of cardiovascular disease. Here, Wang et al. report that from 1990 to 2019, metabolic risk factors have become the leading drivers of IHD worldwide, and IHD-related deaths have largely shifted from regions with a higher sociodemographic index (SDI) to those with a lower SDI.