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Spatial Epidemiology of the Ischemic Heart Disease-Asthma Comorbidity: A Global Analysis of Burden Patterns, Risk

Sha Fan1, Lu Wang1, Shufen Zhang2

  • 1Department of Respiratory Medicine, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, 046000, People's Republic of China.

Risk Management and Healthcare Policy
|June 29, 2026
PubMed

Insights

Global patterns of ischemic heart disease (IHD) and asthma comorbidity show significant spatial variation, particularly in Asia and Africa. Key risk factors include omega-6 fatty acid and iron deficiencies, highlighting the need for integrated health strategies.

Area of Science:

  • Global Health Epidemiology
  • Cardiopulmonary Disease Research
  • Environmental Health Science

Background:

  • Ischemic heart disease (IHD) and asthma are significant global health burdens.
  • The geographical distribution and drivers of IHD-asthma comorbidity are not well understood.

Purpose of the Study:

  • To analyze the global spatial distribution of IHD-asthma comorbidity.
  • To identify macro-level risk factors driving this comorbid pattern.

Main Methods:

  • Secondary analysis of Global Burden of Disease Study 2021 data for 204 countries.
  • Categorization into "concordant", "IHD-dominant", and "asthma-dominant" patterns based on disability-adjusted life years (DALYs).
  • Risk factor identification using random forest, Shapley additive explanations, and negative binomial regression.

Main Results:

  • One-quarter of countries show a "concordant pattern", mainly in Asia, Africa, and Oceania.
  • Thirteen significant risk factors identified; omega-6 polyunsaturated fatty acid and iron deficiencies are common to both.
  • 43.08% of IHD DALYs and 28.96% of asthma DALYs are attributable to combined risk factors.

Conclusions:

  • Global IHD-asthma burden is spatially heterogeneous, with high impact in low-resource regions of Africa and Asia.
  • Comprehensive strategies including nutrition, environmental improvements, and metabolic control are essential.
  • Addressing these comorbidities requires integrated interventions for public health improvement.
Abstract

Keywords:
asthmacomorbidityischemic heart diseasepopulation attributable fractionrisk factors

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