Ischemic heart disease (IHD) remains a leading cause of death globally. This study aims to analyze the burden of IHD in Central Asia and in individual countries of the region from 1990 to 2021, through a comparison of trends in incidence, prevalence, mortality, and disability-adjusted life years. Using data from the Global Burden of Disease (GBD) 2021 study, we extracted annual estimates for the Central Asian region, Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Turkmenistan, Georgia, Armenia, Azerbaijan, and Mongolia. Metrics were reported as age-standardized rates per 100,000 population. Temporal trends were quantified using Average Annual Percent Change based on joinpoint regression models. A stratification by sex and age groups was done. Central Asia consistently maintained a higher IHD burden than the global average. While global age-standardized incidence rates per 100,000 population fell, Central Asia’s rates per 100,000 population rose from 641.97 in 1990 to 801.56 in 2021. Age-standardized death rates per 100,000 population in the region peaked in the mid-1990s following the dissolution of the Soviet Union but decreased overall from 320.47 in 1990 to 265.51 in 2021. However, this remains significantly higher than the 2021 global rate per 100,000 population of 108.73. Uzbekistan exhibited the highest growth in prevalence and incidence rates per 100,000 population, while Georgia demonstrated the largest reduction in DALYs rates per 100,000 population. Men demonstrated a higher burden across most metrics, although the sex gap narrowed in older populations. Central Asia faces rising incidence rates of IHD and burden levels that far exceed global averages. The significant heterogeneity among countries suggests that region-wide generalizations are insufficient and highlights the critical need for targeted, country-specific prevention programs and health system interventions.

Background: Poor sleep quality is an increasingly recognized, modifiable cardiovascular risk factor, yet data among patients with established coronary heart disease (CHD) in Central Asia are scarce. We estimated the prevalence of poor sleep quality and identified its correlates in a Kazakhstani CHD population. Methods: In this multi-center cross-sectional study, 398 patients 6–24 months after an index coronary event were assessed for sleep quality. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI; >5 = poor). Anxiety and depression, physical activity, cognition, and clinical and socio-demographic variables were recorded. Associations were examined using logistic regression with subgroup and interaction analyses. Results: Poor sleep quality was reported by 147 patients (36.9%). In the adjusted model, anxiety was the only independent factor associated with poor sleep (OR 1.88, 95% CI: 1.10 to 3.23). The subgroup analysis suggested anxiety (OR 3.94) and lower education (OR 2.58) as correlates in women, whereas retirement (OR 2.27) and low physical activity (OR 2.31) were linked to poor sleep in men. A significant sex–anxiety interaction demonstrated a weaker anxiety effect in men. Conclusions: More than one-third of CHD patients reported poor sleep quality, driven primarily by anxiety, with distinct sex- and age-specific determinants. Sleep and psychological screening should be integrated into secondary prevention, with personalized approaches.

Background: Physical activity (PA) is central to the secondary prevention of coronary heart disease (CHD), yet real-world adherence is poor, and data from Central Asia are scarce. Methods: In this cross-sectional study (October 2024–May 2025), 402 patients were recruited 6–24 months after an index coronary event at two Kazakh centers. PA was measured by IPAQ-SF and dichotomized as low versus moderate/high IPAQ-SF category. Multivariable logistic regression identified independent associations with low PA. Results: A total of 152 patients (37.8%) had low PA. Activity was almost exclusively ambulatory: 86.3% reported walking but only 19.9% had any moderate and 11.7% any vigorous activity, and only 29 (7.2%) met WHO/ESC recommendations without counting walking. Low PA was independently associated with recruitment in Aktobe (aOR 3.76, 95% CI 1.98–7.34) and obesity (aOR 1.68, 1.04–2.69); professional exercise advice (aOR 0.45, 0.27–0.73) and the absence of depressive symptoms (aOR 0.42, 0.23–0.76) were associated with lower odds of low PA. Advice was often given but inconsistently followed, and the uptake of fitness clubs (5.6%) and walking groups (10.8%) was minimal. Conclusions: More than one in three patients had low PA, and fewer than one in ten met WHO/ESC recommendations when excluding walking. Depression, obesity, and regional disparity and not conventional risk factors characterized inactive patients.

Introduction. Stroke remains a leading cause of death and disability, with rising global burden. Transient ischemic attack (TIA) is often overlooked despite requiring urgent care. Evidence on stroke awareness, intended action, and access to acute care in Kazakhstan is limited. Aim. To assess public stroke awareness and its sociodemographic distribution, test whether knowledge predicts appropriate intended action, describe barriers in the acute stroke pathway, and identify targets for system improvement. Materials and Methods. Two independent cross-sectional online surveys (StrokeTimeBrain v1.4) were conducted in February–April 2026. Module A included community adults aged ≥18 years (n=383), and Module B included patients and caregivers with a suspected stroke/TIA care contact within the previous 24 months (n=397). Outcomes included a composite knowledge score (0–15), three symptom vignettes, and a four-item care-experience scale. Analyses used χ2 tests, nonparametric comparisons, and logistic/Poisson regression adjusted for age, sex, education, residence, and region. Results. Overall knowledge was modest (mean 6.5/15). Only 20.4% identified the ≤4.5-hour thrombolysis window, and reperfusion-treatment awareness was low, although 94.5% knew the emergency number. Knowledge increased with age, while the youngest respondents were least informed. Appropriate “call EMS” responses declined from 83.6% for slurred speech to 60.8% for transient/TIA symptoms (p<0.001). Correct intended action was associated mainly with urban residence (aOR 3.22), not with total knowledge score. Willingness to use telestroke was high (78.1%). Among care users, satisfaction was high (7.9/10), and imaging delay was the main bottleneck (42.1%). Conclusion. Stroke awareness in Kazakhstan was modest and unevenly distributed. Education should emphasize urgency and TIA, while system improvement should prioritize EMS, imaging, and telestroke capacity, especially in weaker regions. Key words: stroke, transient ischemic attack, health knowledge, emergency medical services, patient satisfaction, health services accessibility.