Abstract Body (Do not enter title and authors here): Background: Cardiovascular diseases include a range of disorders damaging the heart and blood vessels, including coronary artery disease, cerebrovascular disease, rheumatic heart disease, and other heart-related disorders, with the mortality mainly attributed to heart attacks and strokes. Despite the decline in cardiovascular diseases over the past few decades, it remains the leading cause of mortality worldwide, with an estimated 17.9 million deaths annually. This study aims to evaluate the demographic disparities and trends in cardiovascular disease (CVD) mortality among older adults in the United States from 1999 to 2020.

Methods: A descriptive analysis was carried out using ICD codes I00-I99 from the CDC-WONDER database, analyzing age-adjusted mortality rates (AAMRs) per 100,000 as an outcome measure for the CVD mortality trends from 1999–2020.

Result: Between 1999 and 2020, there were a total of 25,411,073 CVD-related deaths in the older population. 54.30% (n=13,801,716) in the female population with an AAMR of 2421 (95% CI: 2419.7, 2422.3). The overall trends in mortality showed a decreasing trend from 1999 to 2018 with an APC of -2.58 from 1999 to 2011 [AA3] and -0.61 from 2011 to 2018. This was followed by a sudden increase in mortality rates until 2020 (APC: 6.12, 95% CI: 2.05, 8.36). When considering mortality trends stratified according to genders, a similar decline was seen in trends for both genders as the overall trend. Analysis of death trends according to race/ethnicity revealed that non-Hispanic (NH) American Indian or Alaska Native had the highest AAMR (2426.2). Rural areas had higher mortality (3000.4) as compared to urban areas (2694.9).

Conclusion: Despite the overall decrease in cardiovascular mortality among the different demographics from 1999-2018, this was followed by an increase in cardiovascular mortality among all demographic subgroups from 2018-2020. Hence, signifying the urgent unmet need to mitigate the geographic disparities in cardiovascular morbidity and mortality.