Global burden of ischemic heart disease attributable to ambient PM2.5 pollution from 1990 to 2017

Abstract Objectives We aimed to estimate the spatial and temporal variation in the PM2.5 associated ischemic heart disease (IHD) burden on a global scale between 1990 and 2017. Methods We obtained data on IHD attributable to PM2.5 from the Global Burden of Disease Study (GBD) 2017. We used the numbers and age-standardized mortality rate (ASMR) and disability-adjusted life years (DALYs) rate (ASDR) of IHD attributable to PM2.5 by sex, socio-demographic index (SDI), and countries. We calculated the estimated annual percentage changes (EAPCs) to assess the trends of ASMR and ASDR between 1990 and 2017. We further calculated the contribution of population growth, population aging, and mortality or DALYs changes to the total IHD deaths and DALYs attributable to PM2.5 between 1990 and 2017. Results In 2017, IHD attributable to PM2.5 resulted in 977,140 (95% UI: 838,900–1123,240) deaths and 21.93 million (95% UI: 18.88–25.37) DALYs globally. There has been a significant change of attributable IHD burden, from being a common burden to one that mainly affects low and middle-SDI countries in Asia, Oceania and sub-Saharan Africa. This global change has occurred as a consequence of opposing trends in high-SDI countries and in Asia, Oceania and sub-Saharan Africa, which has led to some Asian countries having the highest IHD burden attributable to PM2.5 in 2017. Conclusions Although the global age-standardized burden of IHD attributable to PM2.5 has decreased from 1990 to 2017, there has been an unpleasant increase in some low and middle-income countries, mainly in Asia, Oceania, and Africa.