Global and national burden of ischemic heart disease attributable to low physical activity among people aged 55 years and older from 1990 to 2021: trend analysis based on the Global Burden of Disease Study 2021

Background: Low physical activity (LPA) is a major risk factor for ischemic heart disease (IHD). This study aimed to estimate the global, regional, national, and sex-age-specific burden of IHD attributed to LPA among people aged 55 years and older from 1990 to 2021. Methods: We leveraged data from the Global Burden of Disease (GBD) Study 2021 to compute the number of fatalities, disability-adjusted life years (DALYs), death rate, and DALY rate attributed to IHD resulting from LPA among individuals aged 55 years and older. Furthermore, we scrutinized the trends and correlations of these metrics in connection with the socio-demographic index (SDI) across 21 regions and 204 countries and territories. The annual percentage changes (APCs) of mortality and DALY rates were estimated using join-point regression model, coupled with age-period-cohort analysis to quantify independent age, period, and cohort effects. Finally, the autoregressive integrated moving average (ARIMA) model was used to predict the disease burden from 2022 to 2036. Results: Globally, from 1990 to 2021, the number of deaths and DALYs due to IHD caused by LPA among individuals aged 55 years and older steadily increased from 1990 to 2021. However, the death and DALY rates decreased during this period. The region with high SDI experienced the largest decrease in death rate (EAPC, -3.06; 95% CI, -3.21 to -2.92) and DALY rate (EAPC, -3.4; 95% CI, -3.59 to -3.22). In 2021, the highest burden was observed in China and India, whereas the lowest burden was recorded in Tokelau and Niue. The age effect indicated a gradually increasing trend over time, indicating age as a significant risk factor for IHD due to LPA among people aged 55 years and older. Period effect identified sustained reductions in mortality and DALY rates over time, with current rates lower than historical levels. Birth cohort analyses indicated a longitudinal cohort effect where in earlier birth cohorts exhibited elevated mortality and rates compared to subsequent cohorts, suggesting progressive temporal improvements in population health outcomes. Predictive analysis suggested that by 2036, the deaths and DALYs will rise while their corresponding rates will continue to decrease. Conclusion: The burden of IHD attributable to LPA among individuals aged 55 years and above remains a significant public health challenge. The distribution of the disease exhibits multi-dimensional disparities across gender, age, geographical region, and SDI. Urgent and effective interventions are essential to promote physical activity and reduce the risk of IHD in middle-aged and elderly populations across diverse demographic groups and regions.