Abstract Body (Do not enter title and authors here): Background:
Obesity has been considered a major threat to cardiovascular diseases, particularly premature cardiac arrest among adults. As obesity continues to rise in the United States (US), there is growing concern about its impact on cardiac mortality. This study aims to assess mortality trends associated with premature cardiac arrest in obese patients in the United States (US) and to identify the affected population.

Methods:
Data for this study were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, which offers detailed information on causes of mortality across the United States. Mortality data related to premature cardiac arrest in individuals with obesity were analyzed. Age-adjusted mortality rates (AAMRs) were estimated, and mortality trends were analyzed using JoinPoint regression to determine the annual percent change (APC).

Results:
From 1999 to 2023, a total of 127,874 deaths were linked to premature cardiac arrest with obesity as a contributing factor. The AAMRs increased from 11.3 in 1999 to 32.6 in 2023, showing a 2.9-fold increase in mortality. A pronounced rise was observed during the COVID-19 pandemic, with the AAMR reaching 50 and an APC of 14.9. Males experienced higher mortality rates compared to females (38.6 vs 26.9 in 2023). Among racial and ethnic groups, Hispanic or Latino individuals had the highest average AAMR, followed by non-Hispanic (NH) Black or African American individuals, NH White individuals, and lastly NH other populations. Geographically, the West among census regions had the highest AAMR and rural areas had higher mortality rates than urban areas.

Conclusion:
This study shows a concerning rise in obesity-associated premature cardiac arrest mortality in the United States from 1999 to 2023, with a 2.9-fold increase in age-adjusted mortality rates. Demographic and geographic disparities were seen, with men, Hispanic and non-Hispanic Black populations, and individuals in rural and western regions facing comparatively higher mortality rates. These findings emphasize the need for public health measures and preventive care.