Key result
Combined IHD and pneumonia mortality drops ~70% among older US adults from 1999 to 2023.
Why the study?
IHD disrupts cardiopulmonary reserve while pneumonia exacerbates cardiac ischemia, but long-term mortality trends and demographic disparities associated with both conditions in the US population remained to be determined.
Observational (n=613,854)
Yes
Mortality from comorbid ischemic heart disease and pneumonia declined significantly from 1999 to 2018 but experienced a sharp, temporary reversal during the COVID-19 pandemic, with persistent disparities among men, older adults, rural residents, and certain racial groups.
Vigilance against pneumonia in older IHD patients should continue; confirms mortality decline was interrupted by COVID-19 and leaves open reasons for persistent demographic and rural disparities.
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.
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Hassan et al. (2026) conducted an observational in Adults aged ≥55 years in the United States with death certificates listing both ischemic heart disease and pneumonia as underlying or contributing causes of death (n=613,854). Age-adjusted mortality rate for ischemic heart disease and pneumonia in US adults aged ≥55 years decreased from 62.8 in 1999 to 18.6 per 100,000 in 2023, with a decline from 1999 to 2018 (APC -6.85%), rise during 2018-2021 (APC +30.09%), then decline again through 2023 (APC -30.32%).
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