People around the world are living longer but with higher levels of sickness, according to the largest ever study of the global burden of disease.
The Lancet analysis shows high blood pressure, smoking and drinking alcohol have become the highest risk factors for ill health.
They replace child malnourishment, which topped the list in 1990.
But some researchers have criticised the way the data was put together, and suggested it is based on poor evidence.
The five-year project, involving almost 500 authors, found heart disease and stroke caused around one in four deaths - almost 13 million - worldwide in 2010.
“
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What ails you isn't necessarily what kills you.”
Prof Christopher Murray
Lead researcher
The burden of HIV/Aids remains high - accounting for 1.5 million deaths that year.
While the age people can expect to live to has increased around the world, the gap in life expectancy between countries with the highest and lowest figures was broadly unchanged since 1970.
Sub-Saharan Africa continues to have a high rate of early death.
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