Abstract Body (Do not enter title and authors here): Background: Ischemic heart disease (IHD) remains a leading global cause of mortality and disability. High fasting blood glucose (FBG) is a significant modifiable risk factor contributing to IHD burden. Understanding trends in this burden is critical for global prevention strategies.
Aim: To assess global, regional, and socio-demographic trends in IHD burden attributable to high FBG from 1990 to 2021 and forecast its trajectory through 2050 using GBD 2021 data.
Methods: We analyzed age-standardized death rates (ASDR), years of life lost (YLL), and disability-adjusted life years (DALYs) from 1990 to 2021. The dataset was globally stratified by continent and by socio-demographic index (SDI). Joinpoint regression was used to calculate average annual percentage changes (AAPC). Forecasting to 2050 employed ARIMA and Poisson models.
Results: Globally, ASDR remained stable between 1990 (17.08; 95% UI 14.58-19.75) and 2021 (ASDR: 16.27; AAPC: -0.15, 95% CI: -0.26 to -0.04). YLLs declined marginally (AAPC: -0.01; 95% CI: -0.12 to 0.10), and DALYs decreased slightly from 304.98 (95% UI: 259.9-351.31) to 303.49 per 100,000 (AAPC: 0.01; 95% CI: -0.10 to 0.12). Regionally, Europe had the highest ASDR in 2021 (20.66; 95% UI: 12.45-16.98), followed by Africa (19.14; 95% UI: 18.67-26.35), America (17.29; 95% UI: 12.64-17.07), and Asia (15.60; 95% UI: 14.09-19.12). Africa showed a consistent rise in ASDR (AAPC: 1.26; 95% CI: 1.17-1.34), especially in Northern regions (ASDR: 43.00). High-middle SDI countries had the highest ASDR (20.12; 95% UI:17.14-23.26), while high SDI countries showed the steepest decline (AAPC: -1.85; 95% CI: -1.96 to -1.73). Conversely, low SDI regions experienced rising ASDRs (AAPC: 0.97; 95% CI: 0.66-1.27). Forecasts predict a global ASDR decline to 13.32 by 2050, with reductions in Europe and Asia but an increase in Africa (26.55).
Conclusion: While global IHD mortality attributable to high FBG is decreasing, remarkable disparities persist. The burden continues to rise in Africa and low-SDI regions, underscoring the urgent need for targeted, equitable prevention and healthcare strategies.