This was followed by ischaemic heart disease (18,121 lives) and cerebrovascular disease (8,657), said the statistics department in a report today.

Chief statistician Uzir Mahidin said this marked the first time in two decades that pneumonia has surpassed ischaemic heart disease as the principal cause of death, except in 2021 when Covid-19 was the leading cause of death in the country.

Uzir said there were 196,965 deaths recorded in 2023, of which 119,652 (60.7%) were medically certified deaths and 77,313 (39.3%) were non-medically certified deaths.

Pneumonia accounted for 15.2% of the medically certified deaths, followed by ischaemic heart disease (15.1%) and cerebrovascular disease (7.2%).

Uzir said the large number of pneumonia deaths was due to infections in the community, especially in individuals with weakened immune systems or pre-existing health conditions after the Covid-19 pandemic.

He also said deaths involving ischaemic heart disease are associated with unhealthy lifestyle practices and diet.

Other risk factors include obesity, smoking, high cholesterol levels, high blood pressure, diabetes, family history and age.

Uzir also touched on the unique patterns in the causes of death by ethnicity, with diabetes more commonly associated with deaths among Malays and Indians, and cancer the leading cause of death among Chinese.

Pneumonia was the principal cause of death for Chinese and other Bumiputera, while ischaemic heart disease was the principal cause of death among the Malay and Indian community.

He also noted the rise in deaths attributed to cancer, with 5,231 deaths recorded in 2001 to 16,545 deaths in 2023 – a 216% increase in over the span of two decades.

Uzir said cancer of digestive organs recorded the highest deaths with 5,054 deaths, followed by cancer of respiratory and intrathoracic organs (2,530) and breast cancer (1,681).