A new study presented at the American Heart Association’s annual meeting reveals a stark rise in heart disease deaths linked to obesity, with mortality rates nearly tripling from 1999 to 2020. This increase is most pronounced among middle-aged men, Black adults, rural residents, and Midwesterners.

Led by Dr. Aleenah Mohsin, a post-doctoral research fellow at Brown University, the research highlights obesity as a critical and worsening risk factor for ischemic heart disease—a condition caused by clogged arteries that limits blood and oxygen flow to the heart, raising the risk of heart attacks.

"Obesity is a serious risk factor for ischemic heart disease, and this risk is going up at an alarming rate along with the increasing prevalence of obesity,” Dr. Mohsin said. “It is important for everyone, especially high-risk groups, to take steps to manage their weight and reduce their risk of heart disease.”

The findings stem from an analysis of public health data over two decades, documenting more than 226,000 obesity-related hart disease deaths. The study found a 5% annual increase in such deaths, with a 243% rise in obesity-related heart disease mortality among men overall, from 2.1 per 100,000 people in 1999 to 7.2 per 100,000 in 2020.

Among middle-aged men (55 to 64 years), deaths surged 165%, rising from 5.5 per 100,000 in 1999 to 14.6 per 100,000 by 2020. Women also faced an alarming rise, with obesity-related heart disease deaths climbing 131%, from 1.6 per 100,000 in 1999 to 3.7 per 100,000 in 2020.

Geographically, the highest rates were reported in Midwestern states, with Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin reporting an age-adjusted rate of 3.3 deaths per 100,000 people. Rural areas had higher rates than urban ones, showing 4 deaths per 100,000 compared to 2.9 per 100,000, respectively. Black adults faced the highest mortality rate across racial groups, reaching 3.9 deaths per 100,000.

Dr. Sadiya Khan, a cardiologist and spokesperson for the American Heart Association, noted that the increase in obesity-related heart disease deaths exceeded the rise in overall obesity rates, which grew from about 30% to 40% over the same period. “The relative change in ischemic heart disease deaths related to obesity…was greater than the overall increase in obesity prevalence that we’ve seen in the United States," said Dr. Khan.

Khan pointed out that growing awareness of obesity’s risks may influence reporting, as more clinicians now include obesity on death certificates. “The important thing is that we know we need to do more to identify, manage, and treat obesity-related risk.”

Dr. Mohsin emphasized the importance of lifestyle interventions, such as healthier eating, regular exercise, and routine heart health check-ups, particularly for high-risk groups.

As this study is based on findings presented at a medical conference, the results are considered preliminary until published in a peer-reviewed journal.