From 1999 to 2023, age-adjusted mortality rates for stroke and non-ischemic heart disease decreased from 184.51 to 97.9 per 100,000, with significant disparities by sex and race.
Mortality rates for stroke and non-ischemic heart disease in older US adults have significantly declined from 1999 to 2023, but substantial demographic and geographic disparities remain.
BACKGROUND: Stroke and non-ischemic heart disease, often together, have been causing significant challenges worldwide for a long time. Advances in healthcare procedures and public health policies over the past two decades have aimed to reduce the burden of these diseases. Analyzing the long-term mortality trends associated with both conditions is necessary to evaluate the effectiveness and the limitations of these health reforms. This study aims to assess the trends in mortality due to stroke and non-ischemic heart disease in US adults aged > 65, stratified by demographics and geography. METHODS: We conducted a detailed retrospective analysis of the CDC Wonder mortality data from 1999 to 2023 for individuals aged 65+ years. Non-ischemic heart disease and stroke patients were identified using ICD-10 codes I30-I51 and I60-I64 respectively. Age-adjusted mortality rates (AAMR) per 100,000 were calculated, and trends were analyzed by gender, race, region and metropolitan status. Join-Point regression was used to calculate annual percentage changes (APC) with 95% Confidence Intervals (CI). Statistical significance was defined as p < 0.05. RESULTS: A total of 1,307,628 deaths were attributed to Stroke and non-ischemic heart disease in individuals from 1999-2023. The AAMR per 100,000 decreased from 184.51 in 1999 to 97.9 in 2023. From 1999-2023, both sexes show reductions with higher AAMRs in males (194.54-108.2) compared to females (176.62-89.43). The Non-Hispanic (NH) Black or African American displayed the highest overall AAMR (156.6), followed by NH Asian or Pacific Islander (122.35), NH White (121.97), and Hispanic or Latino (112.32). Geographically, the AAMR for the West ranged from 226.34 in 1999 to 110.16 in 2023, followed by the South (182-95.86), the Northeast (178.78-93.99), and the Midwest (159.73-91.61). Nonmetropolitan areas had the highest overall AAMR (137.3) while metropolitan areas had the lowest (121.04). CONCLUSION: Mortality rates due to stroke and non-ischemic heart disease have decreased in the United States over the last two decades. However, significant disparities still exist across different sexes, age, race/ethnicity, and geographic regions. These disparities highlight the need for targeted interventions and improvement of clinical care facilities in high-risk populations.
Jairamani et al. (2026) studied this question. From 1999 to 2023, age-adjusted mortality rates for stroke and non-ischemic heart disease decreased from 184.51 to 97.9 per 100,000, with significant disparities by sex and race.