Global burden of ischemic heart disease due to insufficient physical activity in middle-aged and elderly populations from 1990 to 2021 and projections for 2050

Background: With the consistent growth of aging population, ischemic heart disease (IHD) has become one of the primary causes of death among middle-aged and elderly individuals. This study analyzes the global, regional, and national trends and characteristics of IHD due to physical inactivity over the past 32 years. Methods: Using data from the 2021 Global Burden of Disease (GBD) study, we assessed the burden of IHD due to physical inactivity among middle-aged and elderly populations from 1990 to 2021. Key metrics included the number of disability-adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), Death, and the age-standardized rates of DALYs (ASDALYR), Deaths (ASDR), LYDs (ASYLDR), and YLLS (ASYLLR). Trend analysis used the estimated annual percentage change (EAPC) method. Decomposition and equity analyses were conducted to evaluate the contributions of demographic and epidemiological factors to the observed changes in IHD burden. Autoregressive integrated moving average (ARIMA) model provides future projections. Results: Globally, the number of IHD health burden due to physical inactivity in the middle-aged and elderly population increased significantly from 1990 to 2021. The EAPCs of ASDALYR, ASYLDR, and ASYLLR were -0.35 (95% CI: -0.70 to -0.01), -0.25 (95% CI: -0.70 to 0.20), and -0.37 (95% CI: -0.72 to -0.03), respectively. The ASYLDR exhibited an upward trend, with an EAPC of 0.65(95% CI: 0.32 to 0.99). Globally, the burden increased with age, and in 2021, females bore a higher burden than males. Regional stratification by SDI showed that low-SDI and middle-SDI regions experienced the most notable increases. From 1990 to 2021, Denmark saw the greatest decline in IHD burden, while China exhibited the most substantial rise. Projections using the ARIMA model suggest a continued increase in IHD burden for both sexes by 2050. Conclusion: Marked disparities in the burden of IHD due to physical inactivity exist across regions, sexes, and age groups. This study provides critical evidence to support public health policymaking, with a view toward mitigating the long-term health risks associated with physical inactivity in aging populations.