Global, Regional, and National Burden of Ischemic Heart Disease Due to High LDL Cholesterol, Systolic Blood Pressure, and Fasting Glucose in Young Adults (1990–2021)

Background Young adults aged 25–39 are at high risk for early-onset ischemic heart disease (IHD), with a steadily rising prevalence of metabolic risk factors, including high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure(SBP), and high fasting plasma glucose (FPG). This study aims to assess the global, regional, and national burden of IHD attributable to these factors among young adults from 1990 to 2021. Methods Using data from the Global Burden of Disease Study 2021 (GBD 2021), we analyzed age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate(ASDR) due to IHD attributable to high LDL-C, high SBP, and high FPG among young adults. Pearson correlation and log-linear regression were used to examine trends and associations with the Sociodemographic Index (SDI). Results From 1990 to 2021, the global burden of IHD attributable to high LDL-C, high SBP, and high FPG increased in absolute terms, but age-standardized rates varied. LDL-C-related burden decreased, SBP remained stable, and FPG-related burden significantly increased. Men had higher burdens, with low-middle SDI regions experiencing the highest burden and high-SDI regions the lowest. Disease burden was negatively associated with SDI. Oceania had the highest burden, while high-income Asia-Pacific and Western Europe had the lowest. Central Europe saw the greatest reduction in LDL-C burden, Western Europe in SBP burden, and East Asia in high glucose-related burden. Nauru and the Marshall Islands had the highest burden, while Sweden had the lowest. India, China, and Pakistan, with large populations, contributed significantly to global deaths and disability-adjusted life years(DALYs). Conclusions Between 1990 and 2021, the global burden of IHD attributable to high LDL-C, high SBP, and high FPG among individuals aged 25–39 showed significant variation across time, genders, regions, and countries. While progress has been made in managing some metabolic risk factors, the overall trend remains concerning, highlighting the urgent need for enhanced, multi-level, targeted interventions.