Across 13 Central European countries, 6.71 million people lived with ischaemic heart disease in 2023, 44.8% of them women. Case-fatality, measured as the mortality-to-prevalence ratio, barely moved from 2011 to 2023: 4.49% to 4.37% in men and 4.59% to 4.42% in women. Women fared significantly worse in Croatia (Z = 5.55), Serbia and Czechia; men fared worse only in Poland. Higher national income tracked with lower case-fatality (r = -0.76). Elevated systolic blood pressure, physical inactivity and low intake of fruit, vegetables, nuts/seeds and seafood omega-3 loaded more heavily on women, while tobacco loaded on men.
The pattern fits a familiar story: women's heart disease is diagnosed later, treated less aggressively, and managed against blood pressure and activity targets that often go unmet. For readers, the practical message is that hypertension control and regular physical activity are not optional extras for women, and may carry outsized weight in the regions studied. Caveats matter. This is an ecological analysis of modelled GBD estimates, not individual-level data, so it shows association rather than causation. The case-fatality index normalises attributable deaths to prevalence, which can blur differences in diagnosis, treatment access and data quality between countries. Only 13 countries underpin the income correlation. Dietary findings are risk-attribution outputs, not measured intake effects. Editorially, this is confirmatory: it reinforces known sex disparities and the value of blood pressure and lifestyle prevention, while usefully showing that the disadvantaged sex varies by country.