Most IHD Deaths Linked to Modifiable Risks

Modifiable risk factors accounted for an estimated 88.7% of ischemic heart disease (IHD) deaths in the US in 2023, according to a systematic analysis published in JAMA Cardiology. High systolic blood pressure (SBP), dietary risks, and high low-density lipoprotein cholesterol (LDL-C) were the largest contributors.

Investigators used vital records and epidemiologic data from the Global Burden of Disease Study 2023 to estimate IHD mortality and the burden attributable to 12 metabolic, behavioral, and environmental risk factors from 1990 through 2023. Outcomes included mortality rates, death counts, and attributable risks by age, sex, and state.

An estimated 473,000 IHD deaths occurred nationwide in 2023. Despite this burden, the age-standardized mortality rate decreased by 58.7% from 1990. Between 2010 and 2023, IHD mortality rates declined by 19.0% among males and 24.5% among females.

High SBP was associated with an estimated 47.2% of IHD deaths in 2023, followed by dietary risks at 38.6% and high LDL-C at 28.5%. Since 1990, exposure to high body mass index (BMI) increased by 54.5%, while exposure to high fasting plasma glucose (FPG) increased by 38.8%. IHD deaths attributable to high BMI and high FPG increased by 12.5% and 10.5%, respectively. In contrast, attributable IHD mortality associated with smoking decreased by 33.3%, and mortality associated with particulate matter pollution decreased by 74.9%.

The authors concluded that modifiable risk factors remain major contributors to IHD mortality despite the long-term decline in age-standardized death rates. They identified increasing contributions from high BMI and high FPG as areas of particular concern for efforts to reduce the population burden of IHD.

Source: 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