What does this research mean for the field?

Significant disparities in aortic stenosis and heart failure related mortality persist across sex, race, and geography in the United States, despite stabilization of overall mortality rates in recent years. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

Evaluate mortality patterns for aortic stenosis and heart failure over two decades with a focus on disparities.

March 14, 2026Open Access

Disparities in aortic stenosis and heart failure related mortality trends by sex, race, and geography in United States: A two-decade perspective

Key Result

Aortic stenosis and heart failure mortality rates stabilized since 2011, yet disparities persist among males, older adults, and non-Hispanic Whites.

Key Points

Evaluate mortality patterns for aortic stenosis and heart failure over two decades with a focus on disparities.
Analyzed national mortality data from the CDC WONDER database from 1999 to 2023.
Included individuals aged ≥45 years with aortic stenosis and heart failure.
Used Joinpoint regression analysis to examine trends in mortality rates by sex, race, geography, and age.
Overall age-adjusted mortality rates increased until 2011 and stabilized through 2023.
Mortality rates were higher among males, older adults, non-Hispanic Whites, and rural populations.
AAMR in older adults was approximately 80 times higher than in middle-aged groups.

Structured PICO

Population

Individuals aged ≥45 years with aortic stenosis (AS) and heart failure (HF) in the United States (236,504 deaths recorded).

Outcome

Trends in age-adjusted mortality rates (AAMRs) across age, sex, race, geography, and urbanization from 1999 to 2023hard clinical

While national mortality rates for aortic stenosis and heart failure in the US have stabilized since 2011, significant demographic and geographic disparities persist, highlighting the need for targeted interventions.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

This study aimed to evaluate two decades of U.S. mortality patterns in patients with aortic stenosis (AS) and heart failure (HF), focusing on disparities by sex, race, and geography. Retrospective Study. Using the CDC WONDER database, we examined national mortality data from 1999 to 2023. Individuals aged ≥45 years with AS and HF were included. Trends in age-adjusted mortality rates (AAMRs) across age, sex, race, geography, and urbanization using Joinpoint regression analysis. A total of 236,504 deaths were recorded. Overall AAMR increased until 2011 (APC: 0.78, AAMR 9.42), then stabilized through 2023 (APC: 0.07, AAMR 9.45). Mortality rates were consistently higher among males, older adults >65 years, non-Hispanic Whites, rural populations, and the Midwest region. AAMR in older adults was approximately 80 times higher than in middle-aged groups. Although national mortality rates for AS and HF have stabilized in recent years, they are still on the rise and significant disparities persist across demographic and geographic groups. These findings highlight the need for equitable healthcare access and targeted interventions to reduce preventable cardiovascular deaths. Central Illustration: Aortic stenosis and heart failure related mortality trends in USA from 1999 to 2023.