Smoking And High Blood Pressure Each Account For One In Five Deaths In US Adults
high blood pressure and being overweight are the leading preventable
risk factors for premature mortality in the United States, according to
a new study led by researchers at the Harvard School of Public Health
(HSPH), with collaborators from the University of Toronto and the
Institute for Health Metrics and Evaluation at the University of
researchers found that smoking is responsible for 467,000 premature
deaths each year, high blood pressure for 395,000, and being overweight
for 216,000. The effects of smoking work out to be about one in five
deaths in American adults, while high blood pressure is responsible for
one in six deaths.
the most comprehensive study yet to look at how diet, lifestyle and
metabolic risk factors for chronic disease contribute to mortality in
large magnitude of the numbers for many of these risks made us pause,"
said Goodarz Danaei, a doctoral student at HSPH and the lead author of
have hundreds of thousands of premature deaths caused by these
modifiable risk factors is shocking and should motivate a serious look
at whether our public health system has sufficient capacity to
implement interventions and whether it is currently focusing on the
right set of interventions." Majid Ezzati, associate professor of
international health at HSPH, is the study's senior author.
researchers also found large effects from a series of other preventable
dietary and lifestyle risk factors. Below are the numbers of deaths in
the U.S. due annually to each of the individual risk factors examined:
High blood pressure: 395,000
Inadequate physical activity and inactivity: 191,000
High blood sugar: 190,000
High LDL cholesterol: 113,000
High dietary salt: 102,000
Low dietary omega-3 fatty acids (seafood): 84,000
High dietary trans fatty acids: 82,000
use: 64,000 (alcohol use averted a balance of 26,000 deaths from heart
disease, stroke and diabetes, because moderate drinking reduces risk of
these diseases. But these deaths were outweighed by 90,000
alcohol-related deaths from traffic and other injuries, violence,
cancers and a range of other diseases).
Low intake of fruits and vegetables: 58,000
Low dietary poly-unsaturated fatty acids: 15,000
the deaths calculated in the study were considered premature or
preventable in that the victims would not have died when they did if
they had not been subject to the behaviors or activities linked to
their deaths. All of these risk factors are modifiable through a range
of public health and health system interventions.
earlier studies had quantified deaths linked to a few factors, like
smoking and alcohol, this is the first to look at a wide range of risk
factors, including those linked to diet, lifestyle and metabolic
factors, and the first to do so for the whole U.S. population. This is
also the first to use methods that allowed a true comparison of a
diverse set of risks in terms of how many deaths each of the risk
factors is responsible for. The researchers analyzed data from a number
of public sources, including from the National Center for Health
Statistics and numerous published epidemiological studies and clinical
researchers also found differences between the preventable causes of
death among men and women. High blood pressure was the leading cause of
death in adult women, killing nearly 230,000 American women each year,
19 percent of all female deaths. By comparison, that is more than five
times the 42,000 number of annual deaths in women from breast cancer.
Smoking was the leading cause of death in men, killing an estimated 248,000 annually, or 21 percent of all adult male deaths.
mortality effects of many other risk factors were about equal in men
and women, with alcohol use being a major exception. Seventy percent of
all deaths caused by alcohol were among men and represented 45,000
deaths, a result the researchers said was because men consumed more
alcohol and engaged in more binge drinking.
findings should be a reminder that although we have been effective in
partially reducing smoking and high blood pressure, we have not yet
completed the task and have a great deal more to do on these major
preventable factors," said senior author Ezzati. "The government should
also use regulatory, pricing, and health information mechanisms to
substantially reduce salt and trans fats in prepared and packaged foods
and to support research that can find effective strategies for
modifying the other dietary, lifestyle, and metabolic risk factors that
cause large numbers of premature deaths in the U.S."
research was supported by a cooperative agreement from the Centers for
Disease Control and Prevention through the Association of Schools of
For more information on the Harvard School of Public Health, visit www.hsph.harvard.edu.