National trends in heart failure and hyperlipidemia related mortality in the United States, 1999-2024: Demographic and regional disparities with machine learning based forecasting to 2035.

Cardiovascular disease remains the leading cause of death in the United States, with heart failure (HF) and hyperlipidemia substantially contributing to mortality. This study aimed to examine national trends in HF-related mortality with coexisting hyperlipidemia from 1999 to 2024 and project future mortality patterns through 2035. Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Deaths were identified when heart failure and hyperlipidemia were listed on death certificates using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population and were stratified by sex, race/ethnicity, census region, and urbanization level. Temporal trends were evaluated using joinpoint regression analysis. Forecasts for 2025-2035 were generated using machine learning-based Seasonal Autoregressive Integrated Moving Average (SARIMA) time-series models. From 1999 to 2024, 283,161 deaths involving HF with hyperlipidemia were recorded on death certificates. The AAMR increased from 0.7 to 6.8 per 100,000 population, with a notable increase after 2018. Mortality rates were higher among men than women and were elevated in the non-Hispanic Black and American Indian/Alaska Native populations. Higher rates were also observed in nonmetropolitan counties and in the Midwest and West regions of the United States. Mortality involving HF with hyperlipidemia has increased over the past two decades, with persistent demographic and geographic differences. These findings highlight the importance of continued surveillance and targeted prevention strategies to address the cardiovascular health disparities in the United States.