Trends in ischemic heart disease and thromboembolism-related mortality in the United States, 1999–2024: A population-based analysis using CDC WONDER Data

Abstract

Introduction

Ischemic heart disease (IHD) and thromboembolism continue to contribute to significant cardiovascular mortality in the United States in spite of increased prevention and treatment. Underlying both arterial and venous events, such as stroke, pulmonary embolism (PE), and deep vein thrombosis (DVT), is thrombosis. With the aging of the population and increased risk factors such as obesity and diabetes, awareness of long-term trends in mortality is needed. In this article, CDC WONDER data are used to assess national trends in IHD- and thromboembolism-associated mortality from 1999 to 2024, with attention given to variation by age, sex, and race/ethnicity to inform future public health programs.

Methods

Mortality data for IHD-thromboembolism among those aged ≥45 in the US were extracted from the CDC WONDER (1999–2024), using ICD codes I20-I25 (IHD) and I74, I26, I80-I82 (thromboembolism). Age-adjusted mortality rates were calculated per 100,000 and stratified by age, sex, race/ethnicity, geographic region, and urban-rural classification. Joinpoint regression was used to evaluate average annual percentage change (AAPC) and annual percentage change (APC) with 95 % Confidence Intervals (CIs). A p-value of <0.05 was considered significant.

Results

From 1999 to 2024, 70,339 deaths occurred due to IHD and thromboembolism. The AAMR decreased from 2.6 in 1999 to 2.3 in 2024 with an AAPC of −1.16 (95 % CI: −0.58 to −1.82). The AAMR initially inclined to 2.7 in 2001 with an APC of 1.95 (95 % CI: 5.40 to −1.94) followed by a drastic decline to 1.8 till 2018 with an APC of −2.40 (95 % CI: −2.18 to 4.90), afterward, the AAMR again incline to 2.3 in 2021 with an APC of 7.62 (95 % CI: −10.01 to −2.03). The stratified analysis revealed the highest AAMRs across the age group 85 years and older (16.03). Men consistently had higher AAMR than Women (AAMR: 2.7 vs. 1.9). By race, the highest AAMR was noted among NH Black or African American (3.4), followed by NH white (2.2). Regionally, the South showed the highest AAMR (2.4). Non-Metropolitan exhibited the highest AAMR than Metropolitan (AAMR: 12.6 vs. 10.8).

Conclusion

Despite an overall stable age-adjusted mortality trend of ischemic heart disease and thromboembolism between 1999 and 2024, the most recent years have witnessed a disturbing rise. The most notable disparities persist by age, sex, race, and geographic area, with the largest burden in older adults, men, racial minorities, non-metropolitan residents, and residents of the Midwestern U.S. These findings emphasize the need for targeted interventions and equitable public health interventions to reduce mortality among high-risk groups.