Cardiovascular Mortality In Mental Health Disorders: A Population-Based Analysis of US Mortality Data, 1999-2024

Mental health disorders are linked with increased cardiovascular disease and mortality risk, yet national trends in cardiovascular mortality among US adults with mental health disorders remain incompletely characterized. We performed a nationwide multiple cause of death analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database to evaluate long-term trends and demographic patterns in cardiovascular mortality among US adults aged 25 years or older with mental health disorders between 1999 and 2024. Adults with mental health disorders were identified using International Classification of Diseases, Tenth Revision codes F00-F99, and cardiovascular deaths were reported using circulatory system codes (I00-I99). Age-adjusted mortality rates and crude mortality rates were calculated, and Joinpoint regression was used to derive annual percentage change and average annual percent change (AAPC). Between 1999 and 2024, more than 7.2 million cardiovascular deaths occurred among US adults with mental health disorders. Cardiovascular mortality rose steadily through the study period, and across sex, race/ethnicity, age group, geographic region, and urbanization levels. The greatest increases were noted among adults ages 55-64 years (AAPC: 6.90%, P < 0.001), males (AAPC: 5.40%, P < 0.001), and individuals residing in rural counties and the Northeast. Cardiovascular mortality among US adults with mental health disorders increased significantly between 1999 and 2024, highlighting the persistent disparities in this vulnerable population. These findings reinforce the need for integrated cardiovascular and psychiatric care, targeted prevention strategies, and equitable access to healthcare.