High BMI, High Blood Sugar Drive Rising Burden of Ischemic Heart Disease Deaths in US: JAMA
USA: A new analysis published in JAMA Cardiology has found that although ischemic heart disease (IHD) mortality in the United States has declined substantially over the past three decades, increasing rates of obesity and high blood sugar are contributing to a growing share of heart disease-related deaths.
The study, led by Catherine P. Benziger from the Heart and Vascular Center, Essentia Health, Duluth, Minnesota, analyzed data from the Global Burden of Disease (GBD) Study 2023 to estimate the impact of modifiable risk factors on IHD mortality across the US between 1990 and 2023.
Researchers estimated that approximately 473,000 people died from ischemic heart disease in 2023. While the age-standardized IHD mortality rate fell by 58.7% compared with 1990, the study found that nearly 88.7% of all IHD deaths remained attributable to modifiable risk factors, highlighting the continued importance of preventive strategies.
The analysis revealed the following findings:
- High systolic blood pressure was the leading risk factor for ischemic heart disease (IHD) mortality in 2023, contributing to 47.2% of deaths, followed by dietary risks (38.6%) and high LDL cholesterol (28.5%).
- Between 2010 and 2023, age-standardized IHD mortality rates declined by 19.0% in men and 24.5% in women.
- Since 1990, the burden of IHD attributable to high body mass index (BMI) increased by 54.5%, while the burden linked to high fasting plasma glucose (FPG) rose by 38.8%.
- Overall IHD deaths attributable to high BMI and high FPG increased by 12.5% and 10.5%, respectively, compared with 1990.
- The attributable burden of IHD mortality associated with smoking declined by 33.3%, while the burden linked to particulate matter pollution decreased by 74.9% since 1990.
The findings were based on nationwide vital registration records and epidemiological data. The GBD 2023 investigators evaluated 12 metabolic, behavioral, and environmental risk factors, using advanced statistical models to estimate disease burden by age, sex, and US state.
The authors concluded that although substantial progress has been made in reducing ischemic heart disease mortality, the growing influence of obesity and elevated blood glucose threatens these achievements. They emphasized that addressing barriers to reducing exposure to modifiable risk factors—particularly those related to metabolic health—is essential for further lowering the burden of ischemic heart disease in the United States.
Reference:
Benziger CP, Stark B, Johnson CO, Roth GA, GBD 2023 US IHD Collaborators. Modifiable Risk Factors and Attributable Ischemic Heart Disease Mortality in US States, 1990-2023: A Systematic Analysis for the Global Burden of Disease Study 2023. JAMA Cardiol. Published online July 15, 2026. doi:10.1001/jamacardio.2026.2435
Next Story