Abstract Body: Background:
Heart disease is the leading cause of death along the United States-Mexico border, where disparities in healthcare access and socioeconomic determinants of health are evident. The interaction of ethnicity, location, and cardiovascular risk factors (including hypertension) necessitates thorough epidemiological investigation. This research examines the temporal trends and racial/ethnic differences in heart disease mortality across four border states from 2011 to 2018.

Methods:
We used mortality data from the CDC's WONDER Multiple Cause of Death Files for California, Arizona, New Mexico, and Texas. ICD-10 codes I00-I09, I11, I13, and I20-I51 were used to classify fatalities due to heart disease. The standard population of the United States in 2000 was used to calculate age-adjusted mortality rates (AAMRs) per 100,000. The analyses were stratified by race/ethnicity and state. Joinpoint regression was used to identify important inflection points in mortality rates.

Results:
Between 2011 and 2018, the AAMR for heart disease in the United States-Mexico border area decreased by 16.7% (from 99.8 to 83.1 per 100,000). Ischemic heart disease caused 64.5% of heart disease-related deaths. New Mexico had the highest mortality rate (112.3), while Texas had the lowest (97.4). Hispanic populations have consistently higher death rates than non-Hispanic Whites. The Joinpoint research showed a break in the falling trend after 2015, particularly among Hispanics, suggesting a significant slowdown in development.

Conclusion:
Although worldwide heart disease mortality has decreased, significant ethnic disparities continue, disproportionately affecting Hispanic communities in border areas. These results culturally appropriate, hypertension-focused drugs as well as border-specific health policy changes. Targeting socioeconomic determinants of health, increasing health literacy, and expanding equitable care delivery are crucial for reducing cardiovascular mortality and increasing population health equality in this vulnerable area.