Background: Atherosclerotic Cardiovascular disease (ASCVD) disproportionately impacts low-middle income countries, such as those in South Asia and understanding future ASCVD rates can inform public policy.
Objective: To project the burden of ASCVD in South Asia till 2040.
Methods: Yearly ischemic heart disease (IHD), stroke, and peripheral artery disease (PAD) counts for South Asia (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) and mid-year population were obtained from Global Burden of Disease (1990-2021) in 5-year age brackets (40-79 years) and estimated mid-year national population (2022-2040) was collected. Age-adjusted prevalence (aaPR) and mortality rate (aaMR) (per 100 000) were projected with Bayesian age-period-cohort models in South Asia (overall, males and females); trends were reported as the estimated annual percent change (EAPC).
Results: Between 2021 – 2040, the IHD aaPR in South Asia was projected to increase [2021: 9434.6 (9432.1, 9437.1), 2040: 9846.6 (8800.0, 10893.3),EAPC: 0.23% (0.08%, 0.37%)] because of increased rates among females [EAPC: 1.16% (1%, 1.32%)]. The overall IHD aaMR will reduce [2021: 254.7 (254.3, 255.1), 2040: 224.0 (166.5, 281.6), EAPC: -0.67% (-1.61%, 0.27%)] but may increase in females [EAPC: 1.16% (1%, 1.32%)]. Stoke aaPR in South Asia is projected to increase slightly [2021: 1065.5 (1064.7, 1066.4), 2040: 1074.6 (953.7, 1195.5)]. The PAD aaPR is projected to increase [2021: 1809.5 (1808.5, 1810.6), 2040: 1879.5 (1684.9, 2074.0), EAPC: 0.26% (0.04%, 0.47%)] because of increased rates in females [EAPC: 0.29% (-0.01%, 0.59%)].
Conclusions: IHD and PAD prevalence rates are projected to increase in South Asia with a disproportionate rise among females.
Editors
JACC: Asia Editor-in-Chief
Jian’an Wang, MD, PhD, FACC
CME Editor
Kenneth A. Ellenbogen, MD
Authors
Valerian Fernandes, MBBS, FACC
Manoj Ambalavanan MD
Important Dates
Date of Release: October 7, 2025
Term of Approval/Date of CME/MOC Expiration: October 6, 2026