Trends and Disparities in Aortic Stenosis–Related Mortality Among Adults Aged ≥65 Years in the United States From 1999 to 2024

Abstract

Background

Aortic stenosis (AS) remains a leading cause of cardiovascular death, yet temporal mortality trends specifically among older adults remain poorly characterized. This study analyzed trends and disparities in AS-related mortality among older adults in the United States from 1999 to 2024.

Methods

Using the CDC WONDER database, we analyzed AS-related deaths among adults aged ≥65 years. Age-adjusted mortality rates (AAMR) and average annual percent change (AAPC) were calculated across demographic and geographic subgroups.

Results

A total of 637,178 deaths were recorded. The overall AAMR for AS-related mortality decreased significantly from 1999 (55.74) to 2024 (52.46) (AAPC, –0.23; P =.004). Although rates rose from 2018 to 2021, a significant decline followed through 2024 (annual percent change, –2.40). Men had consistently higher AAMR than women; mortality remained stable in men (AAPC, –0.06; P = .33), but declined among women (AAPC, –0.35; P =.002). AS-related mortality decreased among patients aged 75 to 84 years, but increased in those ≥85 years (AAPC, 0.28), who had the highest AAMR throughout. Mortality declined in all census regions except for the Midwest, reaching the highest AAMR in 2024 (60.91). Nonmetropolitan areas saw increasing trends, whereas metropolitan areas saw declines. AAMR remained highest among non-Hispanic (NH) White individuals; however, significant decreases were observed in Hispanic/Latino and NH Asian/Pacific Islander populations.

Conclusions

Aortic stenosis–related mortality declined modestly among older adults from 1999 to 2024. However, notable demographic and regional disparities persisted, including higher mortality in men, NH White individuals, older adults ≥85 years, and residents of nonmetropolitan regions and the Midwest. Further investigation and targeted interventions are needed to improve outcomes.