Frontiers in cardiovascular medicine · 2026
Ischemic heart disease mortality trends and disparities in US adults from 1999 to 2023: a CDC WONDER analysis.
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Li Jia, Wang Bolin, Xuan Xuezhen, Zhang Fan, Qian Sichong, Li Haiyang
Аннотация
BACKGROUND: Ischemic heart disease (IHD) remains a leading cause of mortality in the United States, yet it remains unclear whether postpandemic recovery patterns differ across population subgroups.
METHODS: Using CDC WONDER data (1999-2023), we analyzed IHD deaths among US adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) were stratified by sex, race/ethnicity, urbanization, and region; crude mortality rates (CMRs) by age. Urban-rural analyses were restricted to 1999-2020. Joinpoint regression estimated temporal trends, and tests of parallelism assessed between-group differences.
RESULTS: Among 10,200,362 IHD deaths, overall AAMRs declined from 300.8 to 127.07 per 100,000 (average annual percent change, AAPC = -3.51; p < 0.001), with the fastest decline during 2021-2023 (APC = -5.59). Males had higher AAMRs than females (245.58 vs. 138.69; p < 0.001). Non-Hispanic (NH) Black individuals had the highest AAMR (217.58). The steepest age-specific CMR decline occurred at 75-84 years (AAPC = -4.04). Metropolitan areas had lower AAMRs than non-metropolitan areas (189.07 vs. 212.60; p < 0.001). Pairwise tests confirmed significant trend differences across most subgroups (all p < 0.05), except NH Other vs. NH White (p = 0.396).
CONCLUSIONS: Despite sustained IHD mortality declines, significant disparities persist across demographic and geographic subgroups, supporting targeted prevention for high-risk populations.
METHODS: Using CDC WONDER data (1999-2023), we analyzed IHD deaths among US adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) were stratified by sex, race/ethnicity, urbanization, and region; crude mortality rates (CMRs) by age. Urban-rural analyses were restricted to 1999-2020. Joinpoint regression estimated temporal trends, and tests of parallelism assessed between-group differences.
RESULTS: Among 10,200,362 IHD deaths, overall AAMRs declined from 300.8 to 127.07 per 100,000 (average annual percent change, AAPC = -3.51; p < 0.001), with the fastest decline during 2021-2023 (APC = -5.59). Males had higher AAMRs than females (245.58 vs. 138.69; p < 0.001). Non-Hispanic (NH) Black individuals had the highest AAMR (217.58). The steepest age-specific CMR decline occurred at 75-84 years (AAPC = -4.04). Metropolitan areas had lower AAMRs than non-metropolitan areas (189.07 vs. 212.60; p < 0.001). Pairwise tests confirmed significant trend differences across most subgroups (all p < 0.05), except NH Other vs. NH White (p = 0.396).
CONCLUSIONS: Despite sustained IHD mortality declines, significant disparities persist across demographic and geographic subgroups, supporting targeted prevention for high-risk populations.