Mortality trends of ischemic heart disease among patients with obstructive sleep apnea in the United States: A 24-year nationwide analysis.

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep disorder that often coexists with ischemic heart disease (IHD). This comorbidity exacerbates cardiovascular morbidity and mortality, but national estimates of OSA - and IHD-related deaths remain underexplored. This study investigates mortality trends associated with IHD among individuals with OSA in the United States, focusing on sociodemographic and geographic disparities.

METHODS

Using the Centers for Disease Control and Prevention's WONDER (Wide-Ranging Online Data for Epidemiologic Research) database, we analyzed mortality data from 1999 to 2022 for adults aged ≥25 years, identifying deaths with IHD (ICD-10: I20-I25) and SA (ICD-10: G47.3) as contributing or underlying causes. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and analyzed using Joinpoint regression to determine annual percent change (APC) and disparities across demographic and regional subgroups.

RESULTS

From 1999 to 2022, AAMRs for IHD-related mortality in individuals with OSA increased by an average of 8.81 % annually (95 % CI: 8.04-10.03). Gender stratification revealed higher AAMRs in males, with both genders showing significant increases. Racial analysis showed non-Hispanic Whites had the highest AAMRs, followed by Hispanics, while Asian and Pacific Islanders had the lowest rates. Geographic disparities highlighted rural areas and small/medium metropolitan regions as having the highest AAMRs. Regional comparisons showed the Midwest exhibited the greatest burden.

CONCLUSIONS

IHD-related mortality among individuals with OSA has risen significantly, with substantial disparities by sex, race, and geography. These findings highlight the need for targeted public health strategies to manage the growing burden and address inequities in high-risk populations.