If chronic disease is the main threat to modern health, the obvious next question is what drives it.
Researchers have an answer, and it is a ranked list built from one of the largest scientific undertakings in the world.
The Global Burden of Disease study tracks how much health loss each risk factor causes across 204 countries.
The 2023 edition, released in October 2025, puts a clear order on the things quietly shaping how long and how well people live.
TL;DR
- High blood pressure is the single largest driver of health loss worldwide, followed by particulate air pollution and smoking.
- Almost half of all global death and illness in 2023 was linked to 88 modifiable risk factors, meaning risks that can, in principle, be reduced.
- Metabolic risks like high blood pressure, high blood sugar, and high body mass have risen about 50% since 2000, even as some environmental risks have fallen.
Data anchored to the Institute for Health Metrics and Evaluation, Global Burden of Disease 2023, released October 2025.
| wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | Rank | Risk factor |
|---|---|---|---|---|---|---|
| 1 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 1 | High systolic blood pressure |
| 2 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 2 | Particulate matter air pollution |
| 3 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 3 | Smoking |
| 4 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 4 | High fasting plasma glucose (blood sugar) |
| 5 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 5 | Low birthweight and short gestation |
| 6 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 6 | High body mass index |
| 7 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 7 | High LDL cholesterol |
| 8 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 8 | Kidney dysfunction |
| 9 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 9 | Child growth failure |
| 10 | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | emmanuel-ashemiriogwa | 21/08/2026 09:59 AM | 10 | Lead exposure |
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The one at the top
High blood pressure sits alone at number one.
It is a quiet risk, often symptomless, and it is linked to roughly one in five deaths worldwide.
Air pollution ranks second when indoor and outdoor particulate matter are combined, and smoking comes third.
What unites the leaders is that they are largely modifiable.
The study estimates that close to half of all deaths and illnesses in 2023 traced back to 88 risk factors that policy and behavior can influence.
The risks that are rising
The ranking is not static, and the direction of travel is telling.
Metabolic risks, the cluster of high blood pressure, high blood sugar, and high body mass, have climbed roughly 50% since 2000.
Meanwhile, some environmental and development-linked risks, such as unsafe water and household air pollution from cooking fuels, have fallen.
That crossover is the risk-factor fingerprint of the epidemiological transition from the previous article.
As countries develop, the old risks recede, and the metabolic ones advance.
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ELI5
Scientists ranked the factors that most damage people’s health worldwide.
High blood pressure is number one, then dirty air, then smoking.
Many of these can be reduced, and those tied to how we eat and live have been worsening over the last twenty years.
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