Trends and Disparities in Stroke Mortality Among Adults with Hyperlipidemia in the United States, 1999-2023.

Abstract

Background: Stroke is a leading cause of death in the U.S., with mortality trends influenced by hyperlipidemia, a significant risk factor for atherosclerosis and cardiovascular disease that can lead to ischemic stroke. This analysis examines stroke-related mortality in hyperlipidemia among adults aged 25 and older from 1999 to 2023.

Methods: A retrospective analysis of CDC WONDER investigated trends in mortality from Stroke (ICD codes: I60-I69) among Hyperlipidemia patients (ICD codes: E78.0, E78.1, E78.3, E78.4, E78.5) aged 25 and older. Joinpoint regression analysis calculated age-adjusted mortality rates (AAMR) per 100,000 individuals, annual percentage changes (APC), Average Annual Percent Change (AAPC), and 95% confidence intervals.

Results: Between 1999 and 2023, stroke and hyperlipidemia caused 241,308 deaths, with AAMRs of 1.38 in 1999 and 7.46 in 2023, an AAPC of + 7.16 (95% CI: 6.66 to 8.52). Adult men had higher AAMRs than women, with increases for both sexes [AAPC: + 7.20 vs. + 7.10; p < 0.001]. Black individuals had the highest AAMRs, followed by Hispanics. AAMR rose for all races, notably for Blacks/African Americans (AAPC: + 8.63%) and adults aged 65 and above (AAPC: + 7.35%). Northeast regions have the highest AAMRs, with the Midwest showing the most significant rise (AAPC: + 7.86%). AAMRs varied by state, from 2.0 in Georgia to 9.43 in Vermont in 2023. Non-metropolitan areas had higher AAMRs (4.31) than metropolitan areas (3.54).

Conclusion: This analysis reveals significant demographic and racial disparities in Stroke mortality among U.S. adults with Hyperlipidemia, which highlights the urgent need for targeted, equity-focused interventions to address these disparities.