Coronary disease & ACSResearch article
Modifiable Risk Factors and Attributable Ischemic Heart Disease Mortality in US States, 1990-2023
- Systematic analysis of the Global Burden of Disease Study 2023
12 metabolic, behavioral and environmental risk factors; ensemble modeling, bayesian meta-regression and Burden of Proof framework
Authors' conclusion
Per the results of this systematic analysis of GBD 2023, a total of 88.7% (95% UI, 83.4%-92.5%) of IHD deaths were attributable to modifiable risk factors in the US in 2023, with high SBP, dietary risks, and high LDL-C being the greatest contributors.
Study context
- Population
- General population of US states, 1990–2023
- Outcome
- IHD death rates per 100 000 persons, counts and attributable risks by age, sex and US state
- Follow-up
- 1990-2023
Main finding
As reported in the abstract
2023
- Ischemic heart disease (IHD) deaths in the US in 2023
- 473 000 (95% UI 414 000-510 000)
- Decrease in age-standardized IHD death rate since 1990
- 58.7% (95% UI 56.8%-61.0%)
- IHD deaths attributable to high systolic blood pressure (SBP)
- 47.2% (95% UI 36.4%-57.0%)
- IHD deaths attributable to dietary risks
- 38.6% (95% UI 17.2%-56.8%)
- IHD deaths attributable to high low-density lipoprotein cholesterol (LDL-C)
- 28.5% (95% UI 19.3%-39.6%)
- IHD deaths attributable to modifiable risk factors
- 88.7% (95% UI 83.4%-92.5%)
Further findings
Decrease in IHD death rates, 2010–2023, by sex
- Males
- 19.0% (95% UI 15.0%-22.9%)
- Females
- 24.5% (95% UI 20.3%-29.7%)
Change in attributable IHD burden since 1990, by risk factor · 1990-2023
- High fasting plasma glucose: increase
- 38.8% (95% UI 11.5%-81.1%)
- High body mass index (BMI): increase
- 54.5% (95% UI 41.8%-66.3%)
- Smoking: decrease
- 33.3% (95% UI 23.6%-41.7%)
- Particulate matter pollution: decrease
- 74.9% (95% UI 46.7%-88.8%)
Original publication
Modifiable Risk Factors and Attributable Ischemic Heart Disease Mortality in US States, 1990-2023. JAMA Cardiol. Published 1 September 2026. doi:10.1001/jamacardio.2026.2435
Summarised from the published abstract; every number is checked against it