Abstract Body:
Background:
Obesity is a major risk factor for cardiovascular disease, yet its role in cardiac arrest (CA) mortality remains a growing public health concern.

Research Question:
How have CA-related mortality trends among obese adults in the U.S. changed from 1999 to 2023?

Objectives:
To analyze disparities in CA-related mortality among obese adults by age, sex, race/ethnicity, and geographic region.

Methods:
Age-adjusted mortality rates (AAMRs) per million in adults (25+) were obtained from CDC WONDER using ICD codes for obesity (E66) and CA (I46). Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC), with significance at p<0.01.

Results:
Between 1999 and 2023, 128,550 CA-related deaths occurred among obese adults, with most deaths in medical facilities (58.8%). The AAMR rose from 11.3 in 1999 to 32.5 in 2023 (AAPC: 4.45%, 95% CI: 3.72–5.01, p<0.000001). Men had higher AAMRs than women (24.6 vs. 19.5) and a steeper increase (AAPC: 5.34%, p<0.000001). Older adults exhibited higher AAMRs (45.2) compared to younger adults (7.0). Among racial groups, Non-Hispanic (NH) Blacks had the highest AAMR (38.4), while NH Whites saw the largest rise (AAPC: 4.97%, p<0.000001). Mortality varied geographically, with Mississippi reporting the highest AAMR (68.7) and DC the lowest (11.6). The West had the highest regional AAMR (29.0), while Midwest experienced the steepest increase (AAPC: 5.7%, p<0.000001). Rural areas exhibited greater AAMRs than urban regions, both trending upward.

Conclusion:
Trends have been rising, with significant disparities in older men, NH Blacks and Whites, those from the West and rural communities. The increasing burden underscores the need for targeted prevention strategies.