Abstract Wed079: The Changing Landscape of Heart Failure Mortality Trends Among Metabolic Syndrome Patients in the United States (1999–2023

Introduction: Metabolic syndrome (MetS) is a known risk factor for cardiovascular dysfunction, with insulin resistance, diabetes, hypertension and lipid abnormalities contributing to heart failure (HF). Research Question: How have HF and MetS-related mortality trends changed in the U.S. from 1999 to 2023? Aims: To identify disparities and assess variations in mortality by age, sex, race/ethnicity, and geographic region. Methods: Age-adjusted mortality rates (AAMRs) per million among adults (25+) were extracted from CDC WONDER using ICD codes for HF (I50) and MetS (E10–E14, E66, E78, E88, I10). Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC) with significance at p<0.01. Results: Between 1999 and 2023, 2.36 million HF-related deaths occurred among MetS adults, primarily in hospitals (36%) and homes (29%). AAMR rose from 297 in 1999 to 532 in 2023 (AAPC: 2.2%, 95% CI: 1.7–2.9, p<0.000001), peaking in 2021 (567). Men had higher AAMRs than women (469 vs. 376) and a greater increase (AAPC: 2.7%, 95% CI: 2.2–3.4, p<0.000001). NH Blacks had the highest AAMR (559), while NH Whites had the greatest rise (AAPC: 2.5%, 95% CI: 2.0–3.0, p<0.000001). Elderly (75Y+) had higher AAMRs (3254 vs. 127 in 25–44Y), but younger adults showed a steeper increase (AAPC: 4.6% vs. 2.3%, p<0.01). Geographically, AAMRs ranged from 999 (Mississippi) to 258 (Connecticut), with the South showing the highest increase (AAPC: 2.8%, 95% CI: 2.3–3.4, p<0.000001). Rural areas had higher AAMRs than urban (509 vs. 376), with both showing increasing trends. Conclusion: Significant mortality disparities exist in HF among MetS patients, warranting targeted interventions for younger men, NH Blacks and Whites, rural residents, and the South