Temporal Trends in Mortality Due to Ischemic Heart Disease and Cardiac Arrhythmias in the United States From 1999 to 2023
Taha Alam, Sohaima Kamal, Dhvanit Rajdeep, F. N. U. Areesha, Pardeep Kumar, Hamza Yousuf Ibrahim, Muhammad Suleman Khan, Muhammad Ibrahim Rashid, Alisha Ahmed, Muhammad Raafay Jamil, Nicholas Aderinto, Ehsanullah Alokozay, Caleb Karani, Hassaan AbidABSTRACT
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.