Abstract Body (Do not enter title and authors here): Background: Stroke-related mortality has been rising in the United States. Understanding its association with modifiable risk factors, such as hyperlipidemia (HLD), is critical for prevention. This study analyzes trends and disparities in stroke-related mortality among patients with HLD in the United States from 1999 to 2020.
Methods: Using data from CDC WONDER (Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research), we calculated annual stroke-related age-adjusted mortality rates (AAMR) per 100,000 in patients with HLD from 1999 to 2020 and stratified them by sex and race. Stroke-related deaths were defined as those with stroke (ICD-10 I60–I69) as the underlying cause and hyperlipidemia listed as a contributing condition. JoinPoint regression analysis was used to assess trends and estimate annual percent changes (APC).
Results: From 1999 to 2020, there were 58,661 stroke-related deaths in patients with HLD, with an overall AAMR of 0.8 per 100,000. AAMR increased throughout the period, rising rapidly from 0.3 in 1999 to 0.7 in 2006 (APC +13.7%, p<0.001), followed by a slower increase to 1.2 in 2020 (APC +2.8%, p=0.002). Female and male patients exhibited similar trends. AAMR was 0.3 for both sexes in 1999 and rose to 1.1 in females and 1.2 in males by 2020. Initially, Black or African American patients and White patients had similar AAMRs; however, AAMR increased more rapidly in Black patients compared to White patients. Among Black patients, AAMR rose from 0.2 in 1999 to 0.7 in 2004 (APC +24.6%, p<0.001), then further increased to 1.4 in 2020 (APC +4.2%, p=0.001). In White patients, AAMR rose from 0.2 in 1999 to 0.7 in 2006 (APC +13.7%, p<0.001) and to 1.1 in 2020 (APC +2.6%, p<0.001).
Conclusion: Stroke-related mortality in patients with HLD increased steadily from 1999 to 2020. Trends were similar between male and female patients. However, AAMR rose more rapidly among Black patients than White patients, underscoring growing disparities.