Abstract Body (Do not enter title and authors here): Background and Aims
Atherosclerotic diseases, including but not limited to myocardial infarction and stroke, are the leading cause of morbidity and mortality worldwide. Here we aim to identify and quantify temporal trends of atherosclerotic disease mortality among adults in the United States from 1999 to 2020, and pinpoint racial, local, regional, age and gender-wise variations in this trend.

Methods
Data was sourced from the CDC WONDER database, with atherosclerosis identification based on ICD-10 Codes I70. We determined the crude death rates and age-adjusted mortality rates (AAMRs) per 100,000 individuals from 1999-2020. JointPoint regression was employed to examine the changes in AAMR across the years through annual percent change (APC) and the average annual percent change (AAPC).

Results
The AAMR for atherosclerosis shows a uniformly declining trend from 1999 to 2020 with AAPC= -7.25; 95% CI -6.34 to -8.14. The analysis revealed significant disparities in mortality rates among different demographic groups. Mortality was significantly higher among female patients (AAPC=-7.09%; 95% CI -6.48 to -8.58), American Indian patients (AAPC=-7.88%; 95% CI -.6.58 to -9.11), and rural populations (AAPC=-7.62%; 95% CI -6.53 to -8.70). Most deaths occurred in the southern region of the US (AAPC: -7.62%; 95% CI -7.45 to -9.19). A notable exception to this was California which accounted for the highest mortality in the US.

Conclusion
Our nationwide analysis showed an overall decreasing mortality trend due to atherosclerosis among adults in the US. However, the higher mortality rate among females, American Indians, and rural populations is concerning and requires further investigation that can explain and expand on the findings of our study and explain this variation in mortality rates.