Regional Heterogeneity in Ischemic Heart Disease and Ischemic Stroke Burden in Europe, 1990-2023: GBD 2023 and Complementary Mendelian Randomization Evidence.
- 1The First Medical Center, Chinese PLA General Hospital, Beijing, China.
- 2Medical School of Chinese PLA, Beijing, China.
- 3Department of Neurology, Chinese PAP Force Hospital of Beijing, Beijing, China.
Abstract
Background
Ischemic heart disease (IHD) and ischemic stroke (IS) remain major contributors to health loss in Europe, with regional heterogeneity. Comparisons of burden, attributable risks, and genetic evidence remain limited.Methods
Global Burden of Disease (GBD) 2023 estimates for Central, Eastern, and Western Europe from 1990 to 2023 were analyzed. Age-standardized prevalence, incidence, mortality, and disability-adjusted life-year rates were summarized; temporal trends were assessed by Joinpoint regression and 2023 cross-country concordance by Spearman correlation. GBD risk profiles were compared between 1990 and 2023. Complementary Mendelian randomization (MR) evaluated high blood pressure, fasting glucose, and low-density lipoprotein cholesterol (LDL-C).Results
Eastern Europe had the highest 2023 burden. IHD and IS rates were positively concordant across countries (Spearman ρ = 0.681-0.820; all p < 0.001), and regional 1990-2023 average annual percent changes were negative. High systolic blood pressure and high LDL-C remained leading GBD-attributable risks. In MR, genetic liability to high blood pressure was associated with IHD (odds ratio [OR] = 1.354, 95% confidence interval [CI] 1.281-1.433) and IS (OR = 1.351, 95% CI 1.295-1.409), and LDL-C with IHD (OR = 1.610, 95% CI 1.508-1.719); these met the Bonferroni threshold. Fasting glucose showed nominal evidence for IHD, whereas fasting glucose and LDL-C showed no statistically significant associations with overall IS.Conclusions
IHD and IS burdens declined across Europe, but regional inequalities persisted. GBD attribution and MR provide complementary evidence; cardiometabolic risks remain central, while genetic associations differ between IHD and overall IS.
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BibTeX
@article{hu2026regional,
title = {{Regional Heterogeneity in Ischemic Heart Disease and Ischemic Stroke Burden in Europe, 1990-2023: GBD 2023 and Complementary Mendelian Randomization Evidence.}},
author = {Haoyang Hu and Ming Li and Siyuan Zhang and Hong Zhao and Yang Liu and Fei Yang},
journal = {Clinical cardiology},
year = {2026},
month = oct,
doi = {10.1002/clc.70505},
url = {https://europepmc.org/article/MED/42924450},
note = {CC BY},
}
RIS
TY - JOUR
TI - Regional Heterogeneity in Ischemic Heart Disease and Ischemic Stroke Burden in Europe, 1990-2023: GBD 2023 and Complementary Mendelian Randomization Evidence.
AU - Haoyang Hu
AU - Ming Li
AU - Siyuan Zhang
AU - Hong Zhao
AU - Yang Liu
AU - Fei Yang
PY - 2026
DA - 2026/10/01
JO - Clinical cardiology
DO - 10.1002/clc.70505
UR - https://europepmc.org/article/MED/42924450
AB - Background Ischemic heart disease (IHD) and ischemic stroke (IS) remain major contributors to health loss in Europe, with regional heterogeneity. Comparisons of burden, attributable risks, and genetic evidence remain limited.Methods Global Burden of Disease (GBD) 2023 estimates for Central, Eastern, and Western Europe from 1990 to 2023 were analyzed. Age-standardized prevalence, incidence, mortality, and disability-adjusted life-year rates were summarized; temporal trends were assessed by Joinpoint regression and 2023 cross-country concordance by Spearman correlation. GBD risk profiles were compared between 1990 and 2023. Complementary Mendelian randomization (MR) evaluated high blood pressure, fasting glucose, and low-density lipoprotein cholesterol (LDL-C).Results Eastern Europe had the highest 2023 burden. IHD and IS rates were positively concordant across countries (Spearman ρ = 0.681-0.820; all p < 0.001), and regional 1990-2023 average annual percent changes were negative. High systolic blood pressure and high LDL-C remained leading GBD-attributable risks. In MR, genetic liability to high blood pressure was associated with IHD (odds ratio [OR] = 1.354, 95% confidence interval [CI] 1.281-1.433) and IS (OR = 1.351, 95% CI 1.295-1.409), and LDL-C with IHD (OR = 1.610, 95% CI 1.508-1.719); these met the Bonferroni threshold. Fasting glucose showed nominal evidence for IHD, whereas fasting glucose and LDL-C showed no statistically significant associations with overall IS.Conclusions IHD and IS burdens declined across Europe, but regional inequalities persisted. GBD attribution and MR provide complementary evidence; cardiometabolic risks remain central, while genetic associations differ between IHD and overall IS.
SN - 0160-9289
SN - 1932-8737
ER -