Trends in atherosclerotic heart disease-related mortality among U.S. adults aged 35 and older: a 22-year analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background:
Atherosclerotic heart disease (ASHD) remains a leading cause of mortality worldwide, especially among older adults. Understanding the long-term mortality trends in ASHD can guide public health strategies and address demographic disparities.
Methods:
Mortality data for individuals aged 35 years and older were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 persons were calculated and stratified by year, gender, race, urbanization, and place of death. The trends were assessed using the annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals (CI) calculated through Joinpoint regression analysis.
Results:
From 1999 to 2020, 7,638,608 ASHD-related deaths were recorded. The overall AAMR declined from 291.08 in 1999 to 170.07 in 2020, with an AAPC of −2.70 % (95 % CI: 2.96 to −2.54). However, an abrupt rise was observed from 2018 to 2020 (APC: 4.55; 95 % CI: 0.77 to 6.75). Males reported higher AAMR than females (Males: 271.9 vs. Females: 151.9). Non-Hispanic (NH) White individuals had the highest AAMR (209.38), followed by NH Black (202.47), NH American Indian (176.12), Hispanic (158.1), and NH Asian (113.7) populations. Nonmetropolitan areas reported the highest AAMR (214.77), while medium metropolitan areas reported the lowest (195.41). The majority of deaths occurred in medical facilities (42.81 %), followed by decedent's homes (25.67 %), and nursing homes (24.79 %).
Conclusion:
Despite a long-term decline in ASHD-related mortality, the recent increase from 2018 to 2020 requires further study. Gender and racial disparities persist, highlighting the need for targeted public health efforts to reduce these inequities.
Atherosclerotic heart disease (ASHD) remains a leading cause of mortality worldwide, especially among older adults. Understanding the long-term mortality trends in ASHD can guide public health strategies and address demographic disparities.
Methods:
Mortality data for individuals aged 35 years and older were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 persons were calculated and stratified by year, gender, race, urbanization, and place of death. The trends were assessed using the annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals (CI) calculated through Joinpoint regression analysis.
Results:
From 1999 to 2020, 7,638,608 ASHD-related deaths were recorded. The overall AAMR declined from 291.08 in 1999 to 170.07 in 2020, with an AAPC of −2.70 % (95 % CI: 2.96 to −2.54). However, an abrupt rise was observed from 2018 to 2020 (APC: 4.55; 95 % CI: 0.77 to 6.75). Males reported higher AAMR than females (Males: 271.9 vs. Females: 151.9). Non-Hispanic (NH) White individuals had the highest AAMR (209.38), followed by NH Black (202.47), NH American Indian (176.12), Hispanic (158.1), and NH Asian (113.7) populations. Nonmetropolitan areas reported the highest AAMR (214.77), while medium metropolitan areas reported the lowest (195.41). The majority of deaths occurred in medical facilities (42.81 %), followed by decedent's homes (25.67 %), and nursing homes (24.79 %).
Conclusion:
Despite a long-term decline in ASHD-related mortality, the recent increase from 2018 to 2020 requires further study. Gender and racial disparities persist, highlighting the need for targeted public health efforts to reduce these inequities.
Date Issued
2025-03-01
Date Acceptance
2025-02-02
Citation
International Journal of Cardiology. Cardiovascular Risk and Prevention, 2025, 24
ISSN
2772-4875
Publisher
Elsevier
Journal / Book Title
International Journal of Cardiology. Cardiovascular Risk and Prevention
Volume
24
Copyright Statement
© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.ijcrp.2025.200374
Publication Status
Published
Article Number
ARTN 200374
Date Publish Online
2025-02-10