The latest Global Burden of Disease report released Wednesday shows 19.2 million deaths from cardiovascular disease worldwide in 2023, continuing a sharp rise.

Cardiovascular disease, mainly caused by modifiable factors such as such as high blood pressure, obesity and elevated blood sugar levels, caused 1 in 3 global deaths in 2023, with the fastest rises coming in low- and middle-income nations, according to the Global Burden of Disease report released Wednesday. File Photo by Legnan Koula/EPA UPI

ST. PAUL, Minn., Sept. 24 (UPI) -- Some 19.2 million people died of cardiovascular disease in 2023, accounting for 1 in 3 deaths around the world, as risk factors such as obesity continue to rise quickly, according to a major new report released Wednesday.

That death toll from "the world's No. 1 killer" is up from 13 million such fatalities recorded in 1990, according to cardiology data taken from the latest Global Burden of Disease Study and published in the Journal of the American College of Cardiology.

The authors blame the continued acceleration of heart-related deaths and disability on population growth in some parts of the world, "graying" populations in many others and -- importantly -- rising risk factors worldwide.

The authors also found that nearly 80% of all death and disability related to cardiovascular disease in 2023 was attributable to "modifiable risk factors," such as such as high body mass index, elevated blood glucose levels and high blood pressure, which are counted as leading predictors for ischemic heart disease, intracerebral hemorrhage, ischemic stroke and hypertensive heart disease.

The report measures the toll in "disability-adjusted life years," or DALYs -- a combination of the number of years of life lost due to premature death and the number of years lived with disability. Overall, cardiovascular disease-related DALYs have risen 140% since 1990 to 437 million globally, the study found.

As with previous editions, the cardiovascular disease, or CVD, section of year's Global Burden of Disease Study also identified big differences between the 204 nations included in the survey, even among those with similar economies, demonstrating how many varying factors come into play when evaluating local and national burdens of heart disease.

The most-affected countries experienced CVD-related DALYs 16 times greater than the least-affected ones. Generally, however, rates were highest in countries on the low and low-middle spectrum of the Global Socio-demographic Index, which combines information on the economy, education and fertility rates of countries around the world.

The Global Burden of Disease studies, which tap millions of data points generated by thousands of expert contributors around the world, were launched in 1990 and are spearheaded by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

Funded by the Bill and Melinda Gates Foundation, they seek to provide world leaders with the most precise information possible on how CVD, infectious pathogens, mental illness and many other conditions affect their citizens.

The latest results were to be highlighted at a Wednesday event in New York on the sidelines of the the 80th United Nations General Assembly.

Lead author Dr. Gregory Roth, a University of Washington cardiology professor and director for the Program in Cardiovascular Health Metrics at the institute, said that while it's not a surprise that heart disease statistics are continuing their sharply upward trends, some important new information was revealed.

"In this new iteration of the Global Burden of Cardiovascular Diseases, we've added a completely new analysis, which we call the 'decomposition of the drivers' of each of the cardiovascular risk factors," he told UPI. "What that means is we looked separately at why the risk factors are going up or down, and we split it out into four reasons."

The first reason is population growth, "which means more people, more disease," Roth said. "Another is that the population is getting older, and most cardiovascular diseases are much more common among older people than younger people."

A third reason is measurable increases in known CVD risk factors such as high blood pressure, obesity, diabetes and air pollution, while the fourth category is "unknown causes," in which triggers are not immediately apparent, but could be related, to how efficiently a country's healthcare system can deliver beneficial CVD care to its population.

Perhaps the most important takeaway, he added, is that the leading risk factors for CVD "are modifiable, and that we have the interventions that can reduce these risks. Cardiovascular disease is not a foregone conclusion and it can be prevented, especially for the many younger people who suffer from it.

"It's really essential that every country develop a clear strategy and invest in reducing the number-one killer in the world."

The numbers in the latest GBD present an "eye-popping" and distressing assessment of the continued global rise of CVD, said Dr. Karen Joynt Maddox, a professor of medicine and public health at Washington University in St. Louis and an academic researcher for the American Heart Association.

Joynt Maddox, who was not connected with the GBD study, told UPI it provides stark evidence that societies have so far been unable to get a handle on the risk factors driving rampant heart disease.

"I think the thing that struck me is how much of these risk factors are modifiable," she said. "It shows we have just failed at prioritizing health. We've made all sorts of amazing advances on the treatment side of very serious diseases, treating heart attacks and stroke, cardiac valve disease and other things.

"But we really are failing at, for instance, controlling hypertension and getting healthy food to people, and really, so many things that constitute just basic public health."

At a time when the financial and social underpinnings of public health are "under attack," Joynt Maddox said the continuing rise of CVD risk factors across the globe calls for "a rethink" of those policies.

"We can't just keep playing catch-up and dealing with the consequences," she said. "For instance, I would argue that every country needs a strategy to deal with hypertension. We need to be talking in a non-partisan way about how to make sure that everyone can be as healthy as possible, and that certainly includes public health."

Meanwhile, the report found that poor diets -- including the consumption of sugar-sweetened beverages -- were responsible for a global jump in attributable CVD DALYs of 31.4% from 1990 to 2023, prompting the U.S. Academy of Nutrition and Dietetics to note that "diet is a leading modifiable driver of cardiovascular disease.

"While the rise is especially alarming in low- and middle-income countries where CVD is rising fastest and food systems increasingly favor highly processed, low-cost products, this same pattern is occurring in regions with high poverty rates in higher income countries," academy president Deanne Brandstetter told UPI in a statement.

"The most urgent need is to improve access to healthy, affordable and culturally relevant whole foods while reducing consumption of excess sodium, added sugars, and saturated fats," she said. "Registered dietitian nutritionists are essential in helping individuals and communities adopt healthier dietary patterns that can lower CVD risk."

The continuing upswing in risk factors "underscore the urgent need for prevention and early treatment," Brandstetter said.

"Addressing this requires investment in food as medicine initiatives, expanding access to healthy meals for school age children and older adults, and strengthening programs and regulations that expand the availability of nutrient-dense foods and nutrition education across the lifespan." she said.

Equally critical is broadening patient access to registered dieticians and nutritionists and RDN-led medical nutrition therapy, "both to prevent further decline and treat existing conditions," Brandstetter said.