Deaths from coronary artery disease have fallen, but more progress is within reach
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- Global Burden of Disease study published in JAMA Cardiology found U.S. ischemic heart disease deaths dropped more than half from 1990 to 2023, with major gains from declining smoking (-33.3%) and particulate air pollution (-74.9%).
- 419,000 of 473,000 coronary artery disease deaths in 2023 — or 88.8% — were linked to modifiable risk factors, study co-author Gregory Roth of the University of Washington told STAT.
- Higher BMI (up 12.5%) and blood glucose (up 10.5%) since 1990 are reversing prior progress, tied to rising diabetes and the newly named cardiovascular-kidney-metabolic syndrome.
- Kentucky, Tennessee, West Virginia, Mississippi, and Arkansas recorded the highest CAD death rates, while Massachusetts, Oregon, Hawaii, Colorado, and Minnesota saw the lowest; states that adopted tobacco-control policies improved most.
- High blood pressure (47.2%), poor diet (38.6%), and LDL cholesterol (28.5%) drove nearly half of 2023 heart disease deaths, with risk-factor progress stalling since 2010.
- Robert Califf, former FDA commissioner, warned in an accompanying editorial that conflicting federal dietary guidelines, social media misinformation, and a shortage of primary care physicians are undermining further gains.
Why it matters: With 88.8% of 473,000 U.S. coronary artery disease deaths in 2023 tied to modifiable risk factors and progress stalling since 2010, the JAMA Cardiology analysis reframes the country's leading cause of death as a policy and prevention challenge — with BMI, blood glucose, and hypertension as the next battleground.
