Cerebrovascular Disease-Related Mortality Trends Among Adults in the United States: A Retrospective Population-Based...

Background/Objectives: Cerebrovascular disease (CVD) is the fifth leading cause of death in the U.S. and poses marked health ramifications. Improvements in CVD-related mortality rates have been observed since the 1970s, but incidence remains high. It is imperative to analyze demographic disparities and trends in CVD-related mortality to inform better efforts to reduce the burden of CVD. This study aimed to examine demographic disparities in CVD-related mortality across age groups, biological sex, race/ethnicity, and regions from 1999 to 2024. Methods: This was a retrospective population-based study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). The CDC WONDER was used to extract crude and age-adjusted mortality rates (AAMRs) for CVD-related deaths in the US. Adults aged 25 years and older were included in the study. Joinpoint analysis software was used to calculate the annual percent change (APC) and the average annual percent change (AAPC) for mortality trends. Results: There was a total of 6,541,598 CVD-related deaths from 1999 to 2024 in adults aged 25 years and older. The trend in overall CVD-AAMR steadily declined until 2014, then gradually increased, accelerated, and eventually peaked in 2021 during the COVID-19 pandemic. Male individuals experienced a higher mortality rate and comprised 43% of crude deaths vs. 57% of female individuals across the study period. When stratified by race/ethnicity, non-Hispanic (NH) Black individuals had an AAMR that was nearly 1.5 times that of the next-highest group at 148.37 (146.89 to 149.85) per 100,000 people in 2024. The South had the highest AAMR and experienced 39.4% of deaths out of the four regions. All demographics experienced an increase in mortality during the pandemic, but the Northeast region experienced an earlier peak in 2020 as opposed to all other groups, which saw a peak in 2021. Conclusions: CVD-related mortality declined significantly in adults from 1999 to 2024. Differences across demographic and regional subgroups have narrowed; however, significant disparities persist. These disparities will require comprehensive, concerted efforts to improve cerebrovascular health, outcomes, and equity among the young and middle-aged populations in the US.