What 90% of Heart Disease Deaths Have in Common
Heart disease remains the leading cause of death in the United States, despite remarkable advances in medical treatment. A new study published in JAMA Cardiology [1] offers both encouraging news and a sobering reminder: nearly 90% of deaths from ischemic heart disease—the most common form of heart disease—are linked to modifiable risk factors.
The findings reinforce a message that nutrition scientists and public health experts have shared for decades: while genetics certainly influence risk, many of the factors that determine cardiovascular health are within our control.
The Good News
Researchers analyzed data from the 2023 Global Burden of Disease Study, a comprehensive epidemiologic database that integrates information from thousands of health data sources to estimate disease burden and risk factors across the U.S. population from 1990 through 2023.
The encouraging finding is that deaths from ischemic heart disease have declined by nearly 60% in the U.S. during that period. Better treatment of heart attacks, improved blood pressure management, cholesterol-lowering medications, and dramatic reductions in smoking have all contributed to this progress, representing one of modern medicine's greatest public health successes.
The Challenge Ahead
While fewer people are dying from heart disease, the study also highlights an important shift. The three leading contributors to ischemic heart disease deaths today are:
- High blood pressure
- Poor dietary patterns
- Elevated LDL ("bad") cholesterol
Researchers also found that two risk factors have become increasingly important over the past three decades:
- Higher body weight (BMI; Body Mass Index)
- Elevated fasting blood glucose
These trends reflect the growing prevalence of overweight, obesity, insulin resistance, and type 2 diabetes—conditions that increase cardiovascular risk and place additional strain on healthcare systems.
Perhaps the most encouraging finding is that 88.7% of ischemic heart disease deaths were attributable to modifiable risk factors. In other words, the vast majority of premature deaths from coronary artery disease are associated with factors that can be improved through a combination of healthy lifestyle choices, preventive healthcare, and, when appropriate, medical treatment.
Looking Beyond Individual Risk Factors
One of the most important lessons from this research is that cardiovascular risk factors rarely occur in isolation. Individuals with elevated blood pressure often have excess body weight. Those with insulin resistance frequently have abnormal cholesterol levels. Poor dietary habits can contribute to all of these conditions simultaneously.
Rather than viewing blood pressure, cholesterol, blood sugar, and weight as separate problems, it is more useful to recognize them as interconnected markers of overall metabolic health.
This is why lifestyle approaches remain the foundation of cardiovascular disease prevention.
The Mediterranean Diet Connection
For decades, research has consistently shown that the traditional Mediterranean dietary pattern supports cardiovascular health through multiple pathways at once.
A Mediterranean-style eating pattern emphasizes:
- Vegetables and fruits
- Legumes
- Whole grains
- Nuts and seeds
- Extra virgin olive oil as the primary culinary fat
- Moderate amounts of fish and seafood
- Limited intake of highly processed foods and added sugars
Unlike approaches that target a single health outcome, this dietary pattern has been associated with improvements in blood pressure, LDL cholesterol, blood sugar regulation, inflammation, endothelial function, and maintenance of a healthy body weight [2].
This broader perspective helps explain why the Mediterranean diet continues to rank among the most well-studied eating patterns for long-term cardiovascular health.
Know Your Numbers
The authors emphasize that preventing heart disease begins with understanding your own risk.
Regular health screenings should include:
- Blood pressure
- LDL cholesterol
- Blood glucose or HbA1c (a blood test that reflects your average blood sugar over the previous two to three months)
- Body weight and waist circumference
Early identification of changes in these measures allows individuals and their healthcare providers to intervene before cardiovascular disease develops.
The Bottom Line
The new JAMA Cardiology study delivers an encouraging message: heart disease mortality has fallen dramatically over the past three decades.
At the same time, it reminds us that our work is far from finished. As smoking rates have declined, obesity and elevated blood glucose have become increasingly important contributors to cardiovascular disease. The findings underscore the importance of looking beyond any single risk factor and embracing an overall healthy lifestyle.
The encouraging news is that many of these risks remain modifiable. Healthy dietary patterns, regular physical activity, maintaining a healthy weight, avoiding tobacco, and working with healthcare providers to manage blood pressure, cholesterol, and blood glucose continue to offer powerful opportunities to reduce the risk of heart disease.
Putting the Science into Practice
This study reinforces the importance of addressing modifiable cardiovascular risk factors early and consistently. Some individuals choose evidence-based nutritional supplements as part of their overall wellness strategy.
Olivino® Essential was formulated with four proprietary Mediterranean fruit extracts that have been clinically studied to help maintain healthy blood pressure and healthy blood glucose levels already within the normal range—two of the modifiable risk factors highlighted in this new research. Learn more about the science behind Olivino® Essential at OlivinoLife.com.
To your good health!
[1] Benziger CP, Stark B, Johnson CO, et al. Modifiable Risk Factors and Attributable Ischemic Heart Disease Mortality in US States, 1990–2023: A Systematic Analysis for the Global Burden of Disease Study 2023. JAMA Cardiology. Published online July 15, 2026.
Modifiable Risk Factors and Attributable Ischemic Heart Disease Mortality in US States, 1990-2023: A Systematic Analysis for the Global Burden of Disease Study 2023 | Cardiology | JAMA Cardiology | JAMA Network
[2] Hareer LW, Lau YY, Mole F, et al. The Effectiveness of the Mediterranean Diet for Primary and Secondary Prevention of Cardiovascular Disease: An Umbrella Review. Nutrition & Dietetics. 2025;82(1):8-41. https://onlinelibrary.wiley.com/doi/full/10.1111/1747-0080.12891
About the Author
Clare Hasler-Lewis, M.S., Ph.D., MBA, is CEO and Co-Founder of OlivinoLife, Inc., and a nutrition scientist who has spent more than 35 years translating nutrition research into practical health information. She is the author of the Med Diet News series, which explores the latest science on the Mediterranean diet and healthy aging.