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

Authors

Mushood Ahmed
Hira Javaid
Aimen Shafiq
Zain Ali Nadeem
Areeba Ahsan
Abdullah Nofal
Raheel Ahmed
Mahboob Alam
Marat Fudim
Gregg C Fonarow
Mamas A Mamas

Publication Date

11-1-2024

Journal

Endocrinology, Diabetes & Metabolism

DOI

10.1002/edm2.70010

PMID

39462250

PMCID

PMC11512744

PubMedCentral® Posted Date

10-27-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, United States, Male, Female, Obesity, Coronary Artery Disease, Middle Aged, Adult, Aged, COVID-19, Aged, 80 and over, Mortality, Health Status Disparities

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.

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