Trends in coronary artery disease mortality among hyperlipidemic patients: Geographic, gender, and racial insights from CDC WONDER data (1999–2020)

Coronary artery disease (CAD) in hyperlipidemia is a significant cause of mortality among adults in the United States. This study investigates trends in CAD-related mortality in hyperlipidemia among adults aged 25 and older, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020. A retrospective analysis was conducted using the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region. Between 1999 and 2020, CAD in hyperlipidemia led to 407,667 deaths among US adults aged 25+. The AAMR for CAD in hyperlipidemia rose from 4.1 in 1999 to 12.1 in 2020, with an AAPC of 4.44 (95% CI: 3.69 to 5.48, p < 0.000001). Men had higher AAMRs (12.4) than women (5.6), with significant increases for both sexes over time. Racial/ethnic disparities showed the highest AAMRs in Whites (8.9), followed by American Indians/Alaska Natives (8.6). Geographically, AAMRs varied from 3.8 in Alabama to 16.0 in Vermont, with the Midwest showing the highest rates (9.7). Nonmetropolitan areas exhibited higher AAMRs (9.6) than metropolitan areas (8.3), with a more significant increase in nonmetropolitan areas (AAPC: 5.82, p < 0.000001). This study highlights significant disparities in CAD in hyperlipidemia-related mortality among US adults by race, gender, and geography. The overall increase in AAMRs from 1999 to 2020 underscores the need for targeted public health interventions to address these growing inequities. • We have compelling evidence of a significant surge in the age-adjusted mortality rate (AAMR) for coronary artery disease (CAD) among individuals with hyperlipidemia. The AAMR rose from 4.1 in 1999 to 12.1 in 2020, reflecting an Average Annual Percentage Change (AAPC) of 4.44. This increase was particularly pronounced from 1999 to 2006, with an annual percentage change (APC) of 10.02, followed by a more moderate rise from 2006 to 2020, with an APC of 1.76. • Gender disparities in AAMR were notably apparent, with adult men consistently exhibiting higher AAMRs than adult women (overall AAMR for men: 12.4 vs. 5.6 for women). • All racial and ethnic groups experienced varying increases in AAMRs from 1999 to 2020, with the Black population showing the most significant surge. • The disparities in age-adjusted mortality rates (AAMR) across states were striking, ranging from 3.8 in Alabama to 16.0 in Vermont. The highest mortality rates were observed in the Midwestern region, followed by the Western region. • From 1999 to 2020, AAMRs significantly increased in metropolitan and nonmetropolitan areas, with a more pronounced increase observed in nonmetropolitan areas. • The AAMR for CAD in individuals with hyperlipidemia soared from 4.1 in 1999 to 12.1 in 2020, indicating an AAPC of 4.44. In contrast, the AAMR among the general CAD population significantly declined from 230.4 in 1999 to 134.4 in 2020, with an AAPC of -2.69.