Trends in Mortalities due to Sudden Cardiac Arrest in the United States Population

Sudden cardiac arrest is a leading cause of cardiovascular mortality, often occurring without warning and resulting in high fatality rates. Despite advances in prevention and emergency response, disparities in mortality remain rampant across demographic and geographic groups. This study examines long-term trends in sudden cardiac arrest-related mortality in the United States from 1999 to 2023, stratified by sex, race/ethnicity, region, and urbanization level.

Mortality data was extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) were calculated per 100 000 persons using the 2000 U.S. standard population. Joinpoint regression analysis was applied to estimate annual percent changes (APCs) and identify significant shifts in mortality trends.

A total of 8 523 980 SCA deaths were reported during the study period. Overall, the AAMR declined from 196.03 in 1999 to 131.55 in 2023, with the most marked reductions observed after 2021 (APC: -9.63; 95% CI: -13.51 to -5.20; p < 0.000001). Men consistently exhibited higher AAMRs than women (156.08 vs. 111.09 in 2023). Non-Hispanic Black individuals had the highest mortality rates (235.18), followed by Hispanics (184.38). Geographic disparities were evident, with the Northeast and metropolitan areas reporting the greatest AAMRs.

Mortality due to sudden cardiac arrest has declined substantially over the past 25 years, likely driven by improvements in cardiovascular prevention, acute care, and resuscitation practices. However, significant sex, racial, and regional disparities persist, highlighting the need for interventions that are tailored to reduce inequities and improve survival from sudden cardiac arrest.