Background: Ischemic heart disease (IHD) is a leading cause of mortality globally and in the United States which necessitates an understanding of long-term trends to inform interventions. IHD encompasses various conditions such as coronary artery disease and heart attacks, contributing significantly to the global burden of cardiovascular diseases. The high prevalence of risk factors, including obesity, hypertension, and smoking, exacerbates the impact of IHD. This study examines IHD-related mortality trends among US adults from 1999 to 2020, considering demographic and geographic disparities.
Methods: Death certificates from the CDC WONDER database spanning from 1999 to 2020 were analyzed to investigate mortality related to IHD among adults aged 35 years and above. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated, stratified by year, sex, race/ethnicity, and geographic region
Results: Ischemic Heart Disease (IHD) caused 12,756,359 deaths among U.S. adults aged 35 and above from 1999 to 2020. The overall AAMR for IHD-related deaths declined from 48.7 in 1999 to 28.9 in 2020 (AAPC: -2.61; 95% CI: -2.89 to -2.46). The AAMR experienced a substantial decline from 1999 to 2011 (APC: -3.88; 95% CI: -4.57 to -3.66), followed by a marked decrease from 2011 to 2018 (APC: -2.41; 95% CI: -3.51 to -1.13), and then a slight increase from 2018 to 2020 (APC: 4.66; 95% CI: 0.52 to 7.07). Men consistently had higher AAMRs than women, with significant decreases noted in both genders throughout the study period. NH Black or African American individuals exhibited the highest AAMRs, followed by NH White, NH American Indian or Alaska Native, Hispanic or Latino, and NH Asian or Pacific Islander populations. Geographic variations were significant, with the Northeast recording the highest mortality, and West Virginia having the highest state-specific AAMR. Nonmetropolitan areas consistently had higher AAMRs compared to metropolitan areas.
Conclusions: Our analysis from 1999 to 2020 reveals dynamic shifts in Ischemic Heart Disease related mortality trends across the United States. Despite an overall decline in mortality rates, disparities persist among demographic groups and geographic regions. Men consistently had higher mortality rates than women, with significant variations observed among racial and ethnic populations. Regional differences also play a role, with Northeastern and Midwestern states presenting distinct profiles compared to the Southern and Western regions. These findings underscore the imperative for targeted interventions to address disparities and promote equitable health outcomes nationwide.
