Temporal Trends in Mortality Due to Ischemic Heart Disease and Cardiac Arrhythmias in the United States From 1999 to
Taha Alam1, Sohaima Kamal1, Dhvanit Rajdeep2
1Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Insights
Mortality from ischemic heart disease (IHD) and arrhythmias decreased 22% from 1999-2023, but significant disparities persist among demographic and geographic groups in the US.
Area of Science:
- Cardiovascular epidemiology
- Public Health
- Gerontology
Background:
- Ischemic heart disease (IHD) is a leading cause of death in the US.
- Deaths from arrhythmias are increasing.
- Long-term mortality trends for combined IHD and arrhythmias are unclear.
Purpose of the Study:
- To analyze long-term mortality trends for ischemic heart disease (IHD) and cardiac arrhythmias in US adults.
- To identify demographic and geographic disparities in IHD-arrhythmia mortality.
Main Methods:
- Utilized CDC WONDER database (1999-2023) for US adults aged ≥25 years.
- Assessed deaths involving IHD and arrhythmias.
- Calculated age-adjusted mortality rates (AAMR) stratified by demographics and region.
Main Results:
- Total deaths: 1,795,918. Overall AAMR decreased 22% (1999-2023).
- Higher AAMR in men, NH White individuals, older adults, non-metropolitan areas, and Midwest regions.
- Lowest AAMR observed in NH Asian or Pacific Islanders.
Conclusions:
- Despite an overall decline, significant disparities in IHD-arrhythmia mortality persist.
- Targeted public health interventions are needed to address these persistent disparities.
Background:
Ischemic heart disease (IHD) remains a leading cause of mortality in the United States, while arrhythmia-related deaths are increasing. However, long-term mortality trends involving both conditions remain unclear.
Methods:
We utilized the CDC WONDER Multiple Cause-of-Death database to obtain records from 1999 to 2023, targeting US adults aged ≥ 25 years. Deaths involving IHD and arrhythmias were assessed. Age-adjusted mortality rates (AAMR) were calculated and stratified by gender, age, ethnicity, census region, and urbanization.
Results:
A total of 1 795 918 deaths were attributed to both IHD and cardiac arrhythmias between 1999 and 2023. The AAMR declined from 41.97 (95% CI: 41.66-42.27) in 1999 to 32.73 (95% CI: 32.51-32.94) in 2023, representing an overall decrease of 22% (AAPC -0.99). Men had higher AAMRs compared to women (45.0 [95% CI: 44.6-45.5] vs. 23.4 [95% CI: 23.2-23.7]). The highest mortality rate was observed among NH White individuals (AAMR: 34.8; 95% CI: 34.5-35.0), while the lowest was among NH Asian or Pacific Islanders (AAMR: 16.5; 95% CI: 15.6-17.5). Older adults exhibited the higher AAMRs (144.74; 95% CI: 143.60-145.88) compared to younger cohorts. An increased death burden was observed in non-metropolitan (AAMR: 37.1; 95% CI: 36.5-37.8) and Midwest regions (35.5; 95% CI: 34.9-36.0). The majority of the deaths occurred in inpatient facilities (34.7%).
Conclusions:
Although IHD-arrhythmia mortality declined between 1999 and 2023, substantial disparities persisted across demographic and geographic subgroups, highlighting the need for targeted public health interventions.
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