Trends and disparities in mortality associated with peripheral artery disease and hyperlipidemia, 1999-2024

Peripheral artery disease (PAD) with hyperlipidemia adds significantly to the national burden of cardiovascular disease. However, population-level trends in mortality for these conditions are not well understood. We used nationally representative data to investigate long-term temporal patterns and disparities in PAD and hyperlipidemia related mortality in the United States. This descriptive analysis analyzed death records from the CDC WONDER database from 1999 to 2024. The age-adjusted mortality rates (AAMRs) per 100,000 people were calculated for each demographic and geographic strata. AAMRs were standardized to 2000 U.S. standard population. Temporal trends in AAMRs were analyzed using Joinpoint regression to estimate the average annual percent change (AAPC) with 95% confidence intervals (CIs) and p value. Between 1999 and 2024, a total of 148,416 PAD with hyperlipidemia-related deaths were recorded among U.S. adults ≥ 25 years. The national AAMR rose from 0.74 in 1999 to 3.92 in 2024, corresponding to an overall AAPC of 6.32. Both sexes experienced increasing mortality, though men had higher rates and faster growth compared with women. By race/ethnicity, AAMRs increased across all groups, with the steepest relative rise among Hispanic individuals, followed by Non-Hispanic (NH) Black, NH White, and NH Asian or Pacific Islander populations. Geographic disparities were observed, with state-level AAMRs ranging from 0.92 in Georgia to 5.06 in Vermont, and the highest regional mean AAMR in the West (2.93). Finally, rural areas consistently exhibited higher mean AAMRs than urban areas, with slightly steeper increase over time. AAMRs related to PAD and hyperlipidemia have increased more than fivefold, with disproportionately higher rates among men, Hispanic populations, residents of Western regions, and those in rural areas. These patterns suggest widening disparities in vascular health and underscore the need for strengthened preventive efforts, improved lipid management, and more equitable access to cardiovascular care.