Abstract Background Hyperthyroidism is a known risk factor for cardiovascular complications, including arrhythmias, which can contribute to increased mortality. However, national trends in arrhythmia-related mortality among adults with hyperthyroidism remain underexplored. Objective This study aimed to evaluate trends in arrhythmia-related mortality among adults (≥15 years) with comorbid hyperthyroidism in the United States from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Methods Death certificate data from the CDC WONDER database were analyzed to assess trends in arrhythmia-related mortality trends among adults (≥15 years) with comorbid hyperthyroidism from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals, and annual percent change (APCs) and corresponding 95% confidence intervals (CIs) were calculated. Data were stratified by year, sex, race, state and census region. Results Arrhythmia with comorbid hyperthyroidism in adults aged ≥ 15 years resulted in 33,472 deaths, with an overall AAMR of 0.60 (APC - 1.27; 95% CI: -2.02 – -0.51). The AAMR decreased from 0.6 in 1999 to 0.5 in 2018 (APC: -1.88; 95% CI: -2.56 – -1.20), but increased to 0.7 in 2020 (APC: 17.41; 95% CI: -7.07 – 48.37). AAMR values were considerably higher in females when compared to males in 1999 (AAMR women: 0.8 vs men: 0.3), and that trend continued by 2020 (AAMR women: 0.8 vs men: 0.5). Non-Hispanic (NH) Black or African American adults had the highest overall AAMR (0.9), followed by NH White (0.5), NH American Indian/Alaska Native (0.5), NH Asian or Pacific Islander adults (0.5), and Hispanic or Latino (0.4). AAMR did not vary substantially by region (overall AAMR: Northeast: 0.6; Midwest 0.6; South: 0.5; West: 0.7), and non-metropolitan areas had slightly higher AAMR values (0.7) than metropolitan areas (0.6). West Virginia, District of Columbia, Vermont, and California had the highest AAMR values, with rates nearly three times higher than states in the lowest percentile. Conclusion Arrhythmia-related mortality among adults with hyperthyroidism showed an overall decline from 1999 to 2018 but spiked in 2020. Mortality rates were consistently higher in women and NH Black or African American individuals, with minimal regional variation. These findings highlight ongoing disparities and the need for targeted cardiovascular risk management in hyperthyroid patients.
Siraj et al. (Sat,) studied this question.