Trends and Disparities in Ischemic Heart Disease and Pneumonia Associated Mortality in the United States: A Population-Based Retrospective Analysis of Death Records From 1999 to 2023

Ischemic Heart Disease (IHD) disrupts the cardiopulmonary reserve, while pneumonia exacerbates cardiac ischemia, with both being the leading causes of morbidity and mortality in older adults. Our study aimed to determine the long-term mortality trends and demographic disparities associated with IHD and pneumonia in the U.S. population. A retrospective analysis of death certificates listing both IHD and pneumonia as underlying or contributing causes of death was done from 1999 to 2023 using the CDC WONDER database. Age-adjusted mortality rates (AAMRs) were computed per 100,000 individuals and standardized to the 2000 U.S. population. Temporal changes were assessed using Joinpoint regression analysis. Our findings revealed a V-shaped trend showing a significant decline in AAMR from 1999 to 2018, followed by a sharp rise until 2021 (COVID-19) before decreasing again through 2023. Men, older adults, and non-Hispanic (NH) African Americans had a higher mortality burden compared to their demographic counterparts. Geographically, residents of rural regions experienced higher AAMR than those in metropolitan areas. Despite progress in reducing comorbid IHD and pneumonia mortality in the recent two decades, the COVID-19 pandemic caused a significant reversal in these trends. Persistent disparities across racial, gender, and geographic lines highlight the need for targeted public health interventions and improved access to cardiopulmonary care in high-risk populations.