- As of 2021, more than 254 million people globally were living with ischemic heart disease.
- Previous studies show there are several modifiable risk factors for coronary artery disease.
- A new study found that over the last 33 years, these modifiable risk factors have helped to prevent deaths caused by ischemic heart disease.
- Scientists also report that certain modifiable risk factors are attributable to the majority of ischemic heart disease deaths in the United States, with mortality from high BMI and high fasting plasma glucose increasing.
As of 2021, researchers estimate that more than
Also known as coronary artery disease, ischemic heart disease occurs when plaque builds up inside the walls of the arteries, reducing blood flow to the heart.
It can lead to potentially life-threatening heart conditions such as heart attacks, arrhythmia, angina, heart failure, and stroke.
Fortunately, existing research shows there are several modifiable risk factors for ischemic heart disease. And now, a new study published in the journal
However, scientists report that certain modifiable risk factors are attributable to the majority of ischemic heart disease deaths in the United States, and deaths associated with two risk factors — high body mass index (BMI) and high fasting plasma glucose, or fasting blood sugar — increased.
12 heart disease risk factors
For this study, scientists analyzed data from the Global Burden of Disease Study 2023 (GBD 2023), which included information on estimated ischemic heart disease death rate and risk factor exposure for study participants between 1990 to 2023.
The study included information on 12 ischemic heart disease risk factors, including:
- metabolic factors like high LDL cholesterol, high systolic blood pressure, high BMI, and high fasting blood sugar
- behavioral factors, such as
tuxedo ,alcohol consumption and living a sedentary lifestyle - environmental factors like
particulate matter pollution andlead exposure .
“Tracking progress towards the reduction of modifiable risk factors is a key goal for public health scientists,” Gregory Roth, MD, MPH, director of the Program in Cardiovascular Health Metrics, professor of medicine-cardiology at the University of Washington, and lead author of this study, told Medical News Today.
“We are not seeing the progress we should hope for and comparing states helps us to see what can be accomplished in reducing (ischemic heart disease) mortality, when we compare leading and trailing locations,” said Roth.
High blood pressure, cholesterol leading contributors to death risk
At the study’s conclusion, the researchers reported that in 2023 there were 473,000 deaths attributed to ischemic heart disease in the US, which is a decrease of 58.7% from numbers in 1990.
When it came to modifiable risk factors, scientists discovered that about 88.7% of all ischemic heart disease deaths were attributable to modifiable risk factors in the US in 2023.
Of those factors, high systolic blood pressure, dietary risks, and high LDL cholesterol were the leading contributors in 2023, accounting for 47.2%, 38.6%, and 28.5% of ischemic heart deaths disease, respectively.
“These are often risks that cause no symptoms and people are not aware of,” Roth said. “We want to highlight that (ischemic heart disease) is preventable and its risks are modifiable.”
Additionally, researchers found that ischemic heart disease deaths attributable to high BMI and high fasting blood sugar had the largest increases of 12.5% and 10.5%, respectively, since 1990.
“This is the fastest rising risk for (ischemic heart disease),” Roth said. “We need to focus attention on how to disrupt this alarming trend.”
“(Ischemic heart disease) is preventable. Governments and health systems can make key choices to further reduce (ischemic heart disease), and individuals can adopt health behaviors and get screened for risk factors to lower their chance of dying prematurely of (ischemic heart disease).”
–Gregory Roth, MD, MPH
Obesity, diabetes strongest contributors to cardiovascular disease risk
MNT had the opportunity to speak with Carlos Alfonso, MD, cardiologist and director of chronic total obstruction and complex percutaneous coronary intervention at Baptist Health Miami Cardiac and Vascular Institute, part of Baptist Health South Florida, who was not involved in this study.
Alfonso commented that this study’s results are not surprising and are in line with their clinical observations.
“This study highlights what we are seeing in our offices and hospitals daily,” he explained. “While some risk factors for (ischemic heart disease) are decreasing, a large amount of work remains to be done in the prevention of atherosclerotic disease and ischemic heart disease burden.”
“As highlighted by this study, the predominant shift we have noticed in regards to the estimated contribution of (ischemic heart disease) risk factors to the mortality of (ischemic heart disease) is that over the past 30+ years, there has been a decrease in the contribution of smoking in particular to (ischemic heart disease) mortality, but we have seen weight/obesity (as measured by BMI) and emergence of diabetes (as measured by (fasting blood sugar)) as strongest increasing contributors to cardiovascular risk, morbidity and mortality.”
– Carlos Alfonso, MD
“This study showed that mortality rates from ischemic heart disease have decreased greatly over the last 30 years,” added Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who likewise had not been involved in this study.
According to Chen: “These findings are promising, but still show that we have a long way to go given that heart disease still continues to be the
Expert tips for lowering heart disease risk
Renato Apolito, MD, medical director of cardiac catheterization and assistant program director of the Cardiology Fellowship at Hackensack Meridian Jersey Shore University Medical Center in New Jersey told MNT that lowering ischemic heart disease risk is something that is well within a motivated individual’s reach.
“Based on this study, it is clear that a diet low in saturated fat and non-processed food along with daily exercise to maintain a low body mass index while controlling low density lipoprotein (bad cholesterol) with statins or other medications, along with blood glucose level control and smoking cessation would likely cover a large proportion of cardiovascular risk,” Apolito, who was not involved in this study, explained.
When looking at the three modifiable risk factors — high blood pressure, diet, and high LDL cholesterol — which Alfonso has urged individuals to take control of their lives by knowing their numbers.
“Checking their blood pressure regularly and regular checkups with their doctors — (primary care providers), cardiologists, and healthcare teams — are important for early identification of these risk factors,” he continued. “On an individual level, patients can make efforts to control their dietary sugar intakes, eat balanced, heart-healthy diets, and get plenty of exercise with a goal of at least three hours a day a week of exercise.”
“Of concern, the largest increasing risk factors for (ischemic heart disease) deaths over the past 30 years were related to obesity related conditions, including high BMI and high (fasting blood sugar), suggesting the importance of diet, weight, diabetes, and the important contribution to (ischemic heart disease),” Alfonso added.
“Controlling and curbing the national obesity issue is essential to make further strides on a national level,” he emphasized.
