Wang C, Sun Y, Jiang D, et al. - Low‐ and middle‐income countries exhibit a high burden imposed by ischemic heart disease (IHD). There exists a considerable heterogeneity among different income‐classified regions and countries.

• This study utilized comparative risk assessment framework from the 2019 Global Burden of Disease study, to assess population‐attributable fraction and risk‐attributable death and disability‐adjusted life years (DALYs) for IHD in 137 low‐ and middle‐income countries.

• Population‐attributable fraction (%) of IHD deaths, in 2019, due to all modifiable risk factors combined was highest in lower‐middle‐income countries (94.2), followed by upper‐middle‐income countries (93.5) and low‐income countries (92.5).

• In low‐ and middle‐income countries, dietary risks were responsible for the largest proportion of IHD’s behavioral burden, mainly due to diets low in whole grains.

• The 2 main causes of DALYs were high systolic blood pressure and high low‐density lipoprotein cholesterol.

• Compared with 2000 to 2010, there were slower increases in risk‐attributable deaths and DALYs from 2010 to 2019 in upper‐middle income countries, while opposite trends were observed in low‐income countries and lower‐middle income countries.