Abstract Body (Do not enter title and authors here): Background:
Heart failure and vascular diseases remain leading causes of death in the United States. Although mortality declined in the early 2000s, recent years have raised concerns about a resurgence, particularly in certain demographic and geographic groups.
Research Question:
We investigated whether national mortality trends for heart failure and vascular disease in adults aged ≥55 years have shifted over time and whether these changes vary across demographic and geographic subgroups.
Objective:
To assess temporal trends in mortality from heart failure and vascular disease among U.S. adults aged ≥55 years from 1999 to 2019 and examine disparities by sex, race, region, and urbanization to inform targeted interventions.
Methods:
Death certificate data from the CDC WONDER database were analyzed for adults aged ≥55 years with heart failure (ICD-10: I50) and vascular disease (ICD-10: I70–I78) listed as causes of death. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Joinpoint regression was used to estimate annual percent changes (APCs) with 95% confidence intervals (CIs). Trends were stratified by demographic and geographic variables. Statistical significance was defined as p < 0.05(*).
Results:
A total of 264,577 deaths were recorded, most occurring in medical facilities. APCs declined most among women [2001–2012; −6.77* (CI: −7.26 to −6.28)], non-Hispanic Whites [2001–2012; −6.18* (CI: −6.60 to −5.77)], the Midwest [2001–2012; −7.05* (CI: −7.74 to −6.35)], and urban areas [2001–2012; −6.14* (CI: −6.64 to −5.63)]. In contrast, rates rose among men [2012–2019; 1.92* (1.00 to 2.85)], Whites [2012–2019; 1.48* (0.66 to 2.31)], the South [7.68* (0.39 to 15.50)], and urban residents [1.68* (0.72 to 2.64)]. In 2019, AAMRs were highest among men [19.4 (18.96–19.88)], Black individuals [16.0 (15.12–16.89)], the West [17.4 (16.84–18.02)], and rural areas [17.6 (16.94–18.30)]. West Virginia had the highest state-level AAMR [29.5 (28.48–30.57)].
Conclusion:
After a decade of decline, mortality from heart failure and vascular disease among U.S. adults aged ≥55 is rising. The increase is most evident in men, White and Black populations, urban centers, and southern and western regions. The concentration of deaths in institutional settings highlights the need for early prevention and expanded outpatient care. Targeted public health strategies are urgently needed to reverse these trends.