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Deaths from ischemic heart disease (IHD) in the United States have fallen sharply over the past three decades, but rising obesity and high blood sugar are threatening to slow progress, according to a new study published in JAMA Cardiology.
Researchers analyzed data from the Global Burden of Disease Study 2023, covering the period from 1990 to 2023, to assess how modifiable risk factors have influenced deaths from ischemic heart disease, the world’s leading cause of cardiovascular-related illness.
Ischemic heart disease, also known as coronary artery disease, occurs when plaque builds up inside arteries, restricting blood flow to the heart. The condition can lead to heart attacks, angina, heart failure, arrhythmias and stroke.
The study found that ischemic heart disease deaths in the United States fell by 58.7% between 1990 and 2023, with 473,000 deaths recorded last year. Researchers attributed much of this decline to improvements in controlling preventable risk factors.
However, nearly 88.7% of ischemic heart disease deaths in 2023 were still linked to modifiable risk factors, underscoring the need for stronger prevention efforts.
High systolic blood pressure remained the leading contributor, accounting for 47.2% of ischemic heart disease deaths. It was followed by poor dietary habits at 38.6% and high low-density lipoprotein (LDL), or “bad,” cholesterol at 28.5%.
The researchers warned that obesity and diabetes-related conditions are emerging as the fastest-growing threats. Deaths linked to high body mass index (BMI) increased by 12.5% since 1990, while those associated with high fasting blood sugar rose by 10.5%.
Lead author Dr. Gregory Roth, director of the Program in Cardiovascular Health Metrics at the University of Washington, said many of the major risk factors develop without noticeable symptoms, leaving people unaware of the danger.
“Ischemic heart disease is preventable and its risks are modifiable,” Roth said, urging governments, healthcare systems and individuals to prioritize prevention through regular health screenings and healthier lifestyles.
Cardiologists not involved in the research said the findings reflect what they are seeing in clinical practice.
Dr. Carlos Alfonso of Baptist Health Miami Cardiac and Vascular Institute said smoking has become a less significant contributor to heart disease mortality over the past three decades, while obesity and diabetes have emerged as the strongest growing drivers of cardiovascular illness.
Dr. Cheng-Han Chen of MemorialCare Saddleback Medical Center described the decline in heart disease deaths as encouraging but noted that heart disease remains the leading cause of death in the United States, requiring continued public health efforts.
Experts recommended maintaining a healthy weight, following a balanced diet low in saturated fat and processed foods, exercising regularly, controlling blood pressure, cholesterol and blood sugar levels, and quitting smoking to reduce the risk of ischemic heart disease.
Globally, more than 254 million people were living with ischemic heart disease in 2021, highlighting the continuing need for effective prevention strategies and early interventio
