The burden of ischemic heart disease and its attributable risk factors in North Africa and Middle East, 1990-2019: Results from the GBD study 2019.

Background North Africa and Middle East (NAME) region has one of the highest burdens of ischemic heart disease (IHD) worldwide. This study reports the contemporary epidemiology of IHD in NAME. Methods and Results We estimated the incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and premature mortality of IHD, and its attributable risk factors in NAME during 1990-2019 using the results of the Global Burden of Disease study 2019. In 2019, 18.0 million DALYs and 0.8 million lives were lost due to IHD in NAME. During 1990-2019, the age-standardized DALY rate of IHD significantly decreased by 33.3%, mostly due to the reduction of YLL rather than YLD. In 2019, the proportion of premature mortality attributable to IHD was higher in NAME compared with global measures, 26.8% versus 16.9% for women and 18.4% versus 14.8% for men, respectively. The age-standardized DALY rate of IHD attributed to metabolic risks, behavioral risks, and environmental/occupational risks significantly decreased by 28.7%, 37.8%, and 36.4%, respectively. Dietary risk factors, high systolic blood pressure, and high low-density lipoprotein cholesterol were the top three risks contributing to the IHD burden in most countries of NAME in 2019. Conclusions In 2019, IHD was the leading cause of death and lost DALYs in NAME, where premature death due to IHD was greater than the global average. Despite the great reduction in the age-standardized DALY of IHD in NAME during 1990-2019, this region still had the second-highest burden of IHD in 2019 globally.