ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
This article is part of the Research TopicImpact of Environmental Factors on the Health of Children and Older Adults, Volume IIView all 3 articles
Temporal Trends and Global Burden of Ischemic Heart Disease Attributable to Non-Optimal Temperatures from 1990 to 2021: An Analysis of the Global Burden of Disease Study 2021
Provisionally accepted
- 1Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- 2School of Clinical Medicine, Southwest Medical University, Luzhou, China
- 3School of Pharmacy, Southwest Medical University, Luzhou, China
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Background: Global climate change has intensified non-optimal temperature impacts on cardiovascular health. Ischemic heart disease (IHD), a leading cause of mortality, is increasingly linked to temperature anomalies driven by climate change, yet their association remains underexplored. Using Global Burden of Disease (GBD) 2021 data, this study analyzes spatiotemporal trends in temperature-attributable IHD burden from 1990 to 2021. Methods: GBD 2021 data on IHD mortality and disability-adjusted life years (DALYs) across 204 countries were analyzed via joinpoint regression. Stratified analyses by age, sex, region, and sociodemographic index (SDI) assessed subpopulation disparities. Results: In 2021, non-optimal temperatures were responsible for an absolute burden of 610,000 IHD deaths (95% UI: 459, 000 to 862, 000) and 1.24 million DALYs (95% UI: 915,900 to 1.76 million) globally. While these absolute figures represented increases of 41.8% and 37.8% since 1990, the age-standardized mortality rate (ASMR) and DALY rate (ASDR) actually decreased by 3.18% and 55.91%, respectively, over the same period, indicating that population growth and aging are key drivers of the rising absolute count. When examining the attribution of temperatures, the impact of low temperatures (accounting for 81.8% of the burden) was significantly higher than that of high temperatures (accounting for 18.2% of the burden). Regional disparities persisted, with high-SDI regions experiencing the largest decline in ASMR (6.5%), while low/middle-SDI regions faced rising burdens. The impact of high temperatures grew faster in these vulnerable regions. Males had higher absolute deaths and ASMR than females, and elderly populations were most vulnerable. Conclusion: Non-optimal temperatures, particularly rising high-temperature impacts, are critical environmental risks for IHD. The accelerating high-temperature-attributable ASMR over the past decade highlights underestimated risks. Region-specific strategies addressing climatic and demographic vulnerabilities are urgently needed to mitigate future IHD burdens.
Keywords: Global burden of disease, Non-optimal temperature, Ischemic Heart Disease, Climate Change, time trend
Received: 11 May 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 CHEN, Jiang, Wang, Wan, Peng, Luo, Liu and Liu. 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: Mengnan Liu, liumengnan@swmu.edu.cn
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