Nearly All US Heart Disease Deaths Linked to Modifiable Risk Factors, New Research Shows

New research shows that 88.7% of ischemic heart disease deaths in the United States are linked to modifiable risk factors. While overall deaths fell 58.7% from 1990 to 2023, risks from high blood pressure, diet, and cholesterol remain the leading contributors. Alarmingly, deaths linked to high BMI and high fasting glucose rose significantly, highlighting the urgent need for targeted public health policies and early clinical interventions to manage plaque vulnerability.

Ischemic heart disease mortality trends

• ▪The number of ischemic heart disease deaths in the United States decreased by 58.7% from 1990 to 2023.
• ▪As of 2021, an estimated 254 million people globally were living with ischemic heart disease.
• ▪Between 2010 and 2023, the rate of ischemic heart disease deaths decreased by 19% among United States men and by 24.5% among United States women.

Modifiable cardiovascular risk factors

• ▪From 1990 to 2023, the proportion of United States ischemic heart disease deaths attributable to tobacco use decreased from 21.1% to 17.8%, lead exposure decreased from 18% to 16.1%, and airborne fine particulate matter decreased from 14.7% to 4.7%.
• ▪Approximately 88.7% of deaths from ischemic heart disease in the United States were attributable to modifiable risk factors.
• ▪High systolic blood pressure, unhealthy diet, and high LDL cholesterol were the three leading attributable risk factors for death from ischemic heart disease in the United States from 1990 through 2023.

High blood pressure contributions

• ▪High systolic blood pressure accounted for approximately 47.2% of ischemic heart disease deaths in the United States in 2023.
• ▪Dietary risks accounted for approximately 38.6% of United States ischemic heart disease deaths in 2023, while high LDL cholesterol accounted for 28.5%.

Rising obesity mortality rates

• ▪From 1990 to 2023, United States ischemic heart disease deaths attributable to high fasting plasma glucose rose from 12.9% to 18%, representing a 10.5% increase.

Heart disease prevention strategies

• ▪Health policies targeting modifiable risk factors include improving healthcare access, providing affordable medications, and addressing health disparities and social determinants of health.
• ▪A study by Mass General Brigham Heart and Vascular Institute found that a higher burden of modifiable risk factors is associated with more widespread, unstable, and rupture-prone plaques in major coronary arteries.