This analysis used the Global Burden of Disease Study 2023 (GBD 2023) to estimate IHD mortality attributable to 12 modifiable metabolic, behavioral, and environmental risk factors across all US states from 1990–2023, stratified by age, sex, and state.
In 2023, there were ~473,000 IHD deaths in the US, with 88.7% (95% UI, 83.4%–92.5%) attributable to modifiable risk factors. High SBP (47.2%), dietary risks (38.6%), and high LDL-C (28.5%) were the top contributors. Age-standardized IHD death rates fell 58.7% since 1990, but high BMI (+54.5%) and high fasting plasma glucose (+38.8%) attributable burdens rose substantially over the same period.
Full text was not accessible; findings are based on modeled estimates (GBD framework) using vital records and epidemiologic data, which carry inherent uncertainty captured in wide 95% UIs. Risk attribution may underestimate or overestimate individual risk factor contributions due to overlapping exposures and correlation between risk factors.
Nearly 9 in 10 IHD deaths in the US are tied to modifiable risks — prioritize blood pressure control, dietary improvement, and LDL-C reduction in clinical practice. Rising BMI and blood glucose burdens signal an urgent need to intensify obesity and diabetes prevention efforts.
