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. 2024 Nov;7(6):e70010.
doi: 10.1002/edm2.70010.

Trends and Disparities in Coronary Artery Disease and Obesity-Related Mortality in the United States From 1999-2022

Mushood Ahmed  1 , Hira Javaid  2 , Aimen Shafiq  3 , Zain Ali Nadeem  2 , Areeba Ahsan  4 , Abdullah Nofal  5 , Raheel Ahmed  6   7 , Mahboob Alam  8 , Marat Fudim  9   10 , Gregg C Fonarow  11 , Mamas A Mamas  12
Affiliations

Trends and Disparities in Coronary Artery Disease and Obesity-Related Mortality in the United States From 1999-2022

Mushood Ahmed et al. Endocrinol Diabetes Metab. 2024 Nov.

Abstract

Background: Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity-related mortality trends among adults in the United States stratified by age, sex, race and geographical location.

Methods: The CDC-WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis.

Results: From 1999 to 2022, a total of 273,761 CAD and obesity-related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4-4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7-19.1). During the COVID-19 pandemic (2020-2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non-Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8-5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4-4.5).

Conclusions: We observed increasing trends in CAD and obesity-related deaths throughout the study period reaching a peak during the COVID-19 pandemic.

Keywords: CDC WONDER; coronary artery disease; mortality; obesity.

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Conflict of interest statement

Dr. Fonarow reported receiving personal fees from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Eli Lilly, Johnson & Johnson, Medtronic, Merck, Novartis and Pfizer outside the submitted work. Dr. Fudim reported receiving personal fees from Alleviant, Ajax, Alio Health, Alleviant, Artha, Audicor, Axon Therapies, Bayer, Bodyguide, Bodyport, Boston Scientific, Broadview, Cadence, Cardioflow, Cardionomics, Coridea, CVRx, Daxor, Deerfield Catalyst, Edwards LifeSciences, Echosens, EKO, Feldschuh Foundation, Fire1, FutureCardia, Galvani, Gradient, Hatteras, HemodynamiQ, Impulse Dynamics, Intershunt, Medtronic, Merck, NIMedical, NovoNordisk, NucleusRx, NXT Biomedical, Orchestra, Pharmacosmos, PreHealth, Presidio, Procyreon, ReCor, Rockley, SCPharma, Shifamed, Splendo, Summacor, SyMap, Verily, Vironix, Viscardia and Zoll; and receiving grants from the National Institutes of Health, Doris Duke, outside the submitted work. No other disclosures were reported.

Figures

FIGURE 1
FIGURE 1
Overall and sex‐stratified coronary artery disease and obesity‐related age‐adjusted mortality rates (AAMRs) per 100,000 individuals in the United States, 1999–2022.
FIGURE 2
FIGURE 2
Comparison of age‐adjusted mortality rates (AAMRs) per 100,000 individuals before and during COVID‐19 pandemic.
FIGURE 3
FIGURE 3
Coronary artery disease and obesity‐related age‐adjusted mortality rates (AAMRs) per 100,000 individuals stratified by race in the United States, 1999–2022.
FIGURE 4
FIGURE 4
Coronary artery disease and obesity‐related age‐adjusted mortality rates (AAMRs) per 100,000 individuals stratified by urbanisation in the United States, 1999–2020. *Data for urbanisation AAMRs was unavailable for 2021–2022 based on CDC final multiple cause of death data.
See this image and copyright information in PMC

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