Background:
Ischemic heart disease is more prevalent than ischemic stroke in most countries, including the United States; however, recent data suggests that ischemic stroke may be more prevalent in some countries. We performed this study to identify the countries with an inverse ratio of ischemic stroke and ischemic heart disease and associated attributes.
Methods:
We analyzed the data using the Global Burden of Disease (GBD) website; GBD Compare tool published by the Institute for Health Metrics and Evaluation (IHME), Seattle, Washington for the year 2017. We categorized individual 195 countries based on the ratio of ischemic stroke/ischemic heart disease and divided them into ≥1.0, 0,5-99, and <0.5. Gross domestic product (GDP) per capita for each country was calculated using data from Worldometers.
Results:
There were 51, 125, and 19 countries with the ratio of ischemic stroke/ischemic heart disease and divided them into ≤0.5, 0.5-0.99, and ≥1.0 respectively (see Table). The range of ratio was between 0.24 and 1.86. Countries with inverse ratio included China (1.86), North Korea (1.31), Guam (1.28), Taiwan (1.20), Marshall Islands (1.15), Timor-Leste (1.16), South Korea (1.13), Seychelles (1.11), Northern Mariana Islands (1.10), Cambodia (1.09), Federated States of Micronesia (1.08), American Samoa (1.07), Samoa (1.06), Kiribati (1.04), Solomon Islands (1.03), Fiji (1.02), Indonesia (1.02), Mauritius (1.01), and Vanuatu (1.00).
Conclusions:
Approximately 1 out of 10 countries have an inverse ratio of ischemic stroke / ischemic heart disease incidences. The inverse ratio is predominantly driven by a lower incidence of ischemic heart disease.
Global, regional, and national time trends in mortality for congenital heart disease, 1990–2019: An age-period-cohort analysis for the Global Burden of Disease 2019 study
