ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1622108
Global ischemic heart disease burden attributable to environmental risk factors, 1990-2021: An Age-Period-Cohort Analysis
Provisionally accepted
- 1Department of Nursing, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- 2School of Nursing, Southwest Medical University, Luzhou, China
- 3School of Continuing Education, Guiyang Healthcare Vocational University, Guiyang, China
- 4Faculty of Nursing and Midwifery, Jiangsu College of Nursing, Huaian, China
- 5Department of Orthopedics and Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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Background: Ischemic heart disease (IHD) is the leading cause of global deaths. Environmental exposures contribute substantially to IHD burden, yet their combined effects across socio-demographic strata remain poorly characterized.Objective: This study aimed to systematically evaluate the global burden of IHD attributable to environmental factors, analyzing its temporal trends, geographical patterns, and Age-Period-Cohort (APC) effects across different socio-demographic index regions from 1990 to 2021.Methods: Data for this study were obtained from the Global Burden of Disease 2021 (GBD 2021) public dataset to investigate age-standardized deaths rates and disability-adjusted life years (DALYs) rates of IHD attributable to environmental factors from 1990-2021. Environmental factors included particulate matter pollution, non-optimal temperature, and lead exposure. Countries were categorized into five socio-demographic index (SDI) levels. The APC analysis model was employed to disentangle age, period, and cohort effects. Data processing and visualization were conducted using R version 4.4.3.Results: Between 1990-2021, global environmental IHD deaths rates decreased by 31.13% and DALYs rates by 29.85%. High SDI regions achieved 70.39% reduction in deaths rates, while low SDI regions showed only 3.13% decrease. Particulate matter pollution remained the predominant environmental contributor with the highest burdens in South Asia, the Middle East, and North Africa. APC analysis revealed that environmental-related IHD burden increased exponentially with age, with earlier birth cohorts showing substantially higher Risk Ratios (RR). Males consistently demonstrated higher burden than females across all environmental factors.Conclusion: IHD burden attributable to environmental factors shows a declining trend globally but with notable regional and gender disparities. Policymakers in low SDI regions should integrate environmental health into development strategies, high-pollution burden regions should strengthen air quality monitoring and emission control, climate-sensitive regions need to implement temperature adaptation planning, and historically industrialized regions should enhance lead exposure monitoring while ensuring occupational protection for males and environmental health safeguards for the elderly.Keywords: Ischemic heart disease, Environmental factors, Global burden of disease, Age-Period-Cohort analysis, Socio-demographic index
Keywords: Ischemic Heart Disease, environmental factors, Global burden of disease, Age-Period-Cohort analysis, socio-demographic index
Received: 02 May 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Su, Ze, Huang, Guo, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gang Liu, Department of Orthopedics and Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
Baolu Zhang, School of Nursing, Southwest Medical University, Luzhou, China
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