Trends in Mortality Due to Coexisting Chronic Obstructive Pulmonary Disease and Ischemic Heart Disease in the United States, 1999–2020: A Retrospective Observational Study

Objectives: To describe trends in chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD)-related mortality in the United States from 1999 to 2020 using data from CDC WONDER. Methods: This study analyzed mortality data from CDC WONDER, identifying decedents aged 25 years and above using ICD-10 codes. A total of 1,459,562 deaths occurred between 1999 and 2020. Annual crude and age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by age, sex, race, and region. Annual percentage changes (APC) were determined using Joinpoint regression. Results: The overall AAMR declined from 24.78 in 1999 to 18.5 in 2020, with a gradual decrease from 1999 to 2018 (APC = -2.06 [95% CI: -2.27, -1.90]) and a subsequent rise through 2020 (APC = 4.53 [95% CI: 0.56,6.41]). Males had higher AAMRs (28.2) than females (13.95). Non-Hispanic Whites had the highest AAMRs (21.93). Mortality among adults aged 45-64 was stable until 2008, then increased through 2020. For adults ≥ 65 years, AAMRs declined until 2018 but rose sharply thereafter. Non-metropolitan areas (AAMR: 26.29) had higher mortality than metropolitan areas (AAMR: 18.42). States in the 90th percentile, such as Tennessee and Kentucky, had AAMRs approximately three times higher than those in the 10th percentile, including Arizona and Hawaii. Conclusions: Substantial demographic and regional disparities persist in COPD and IHD-related mortality, necessitating targeted interventions in high-risk populations.