Smoking, hypertension cause most premature deaths

NEW YORK Tue Apr 28, 2009 3:18pm EDT

A man holding a cigarette in a file photo. REUTERS/Kim Kyung-Hoon

A man holding a cigarette in a file photo.

Credit: Reuters/Kim Kyung-Hoon

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NEW YORK (Reuters Health) - Hundreds of thousands of deaths every year in the US could be prevented by tackling just a few risk factors, according to a new study out today in the journal PLoS Medicine.

Dr. Majid Ezzati of Harvard University and colleagues estimated the toll of poor diet, high blood pressure, cigarette smoking, sedentary lifestyle and other factors by determining how 2005 mortality data would change if each were eliminated.

For example, they found, if no one in the US smoked, there would have been 467,000 fewer deaths from smoking-related causes, and if everyone had their blood pressure controlled at optimal levels, 395,000 fewer people would have died.

"Targeting a handful of risk factors has a large potential to reduce mortality in the US, substantially more than the currently estimated 18,000 deaths averted annually by providing universal health insurance," Ezzati and his team say. However, they add, even though there are proven ways to help people quit smoking and reduce their blood pressure, "blood pressure and tobacco smoking declines in the US have stagnated or even reversed."

The researchers gauged the number of preventable deaths by looking at 12 different modifiable risk factors, including overweight and obesity, high salt diets, high blood glucose, high LDL cholesterol, physical inactivity, and low fruit and vegetable intake.

A total of 2.4 million people died in the US in 2005. Smoking and uncontrolled hypertension each accounted for nearly one in five deaths. Cigarettes were the leading killer for men, accounting for 21% of deaths in men. For women, high blood pressure was the leading cause of death, representing 19% of female mortality.

Overweight and obesity accounted for 216,000 deaths and inactivity contributed to 191,000. Among the dietary risk factors, the most lethal were high salt intake (102,000 deaths), low intake of omega-3 fatty acids (84,000 deaths) and high trans fatty acid consumption (82,000).

Alcohol use was a double edged sword; if everyone in the US drank moderately, the researchers say, 26,000 fewer people would die from heart disease or diabetes, but 90,000 more would die from alcohol-related diseases like cirrhosis and pancreatitis or alcohol-related accidents and violence.

Strategies targeting individuals and entire populations could be helpful in reducing the mortality risk factors identified in the study, the researchers say. "Combinations of food industry regulation, pricing and better information can also be effective in reducing exposure to dietary salt and trans fatty acids, especially in packaged foods and prepared meals," they add.

In a press release accompanying the study, Ezzati stated: "The findings should be a reminder that although we have been effective in partially reducing smoking and high blood pressure, we have not completed the task and have a great deal more to do on these major preventable risk factors."

SOURCE: PLoS Medicine, online April 28, 2009.

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