Key result
US mortality involving both IHD and cardiac arrhythmias declines ~22% from 1999 to 2023.
Why the study?
IHD remains a leading cause of US mortality while arrhythmia-related deaths are increasing, but long-term mortality trends involving both conditions remain unclear.
Observational (n=1,795,918)
Effect estimate: AAPC -0.99 (95% CI -1.78 to -0.20)
Absolute Event Rate: 32.73% vs 41.97%
p-value: p=0.0147
While overall mortality from coexisting ischemic heart disease and arrhythmias declined by 22% between 1999 and 2023, significant disparities persist, with higher mortality burdens in men, older adults, non-metropolitan areas, and the Midwest.
Declining combined mortality supports sustained prevention; leaves open targeted research on persistent disparities by sex, age, and region.
BACKGROUND: Ischemic heart disease (IHD) remains a leading cause of mortality in the United States, while arrhythmia-related deaths are increasing. However, long-term mortality trends involving both conditions remain unclear. METHODS: We utilized the CDC WONDER Multiple Cause-of-Death database to obtain records from 1999 to 2023, targeting US adults aged ≥ 25 years. Deaths involving IHD and arrhythmias were assessed. Age-adjusted mortality rates (AAMR) were calculated and stratified by gender, age, ethnicity, census region, and urbanization. RESULTS: A total of 1 795 918 deaths were attributed to both IHD and cardiac arrhythmias between 1999 and 2023. The AAMR declined from 41.97 (95% CI: 41.66-42.27) in 1999 to 32.73 (95% CI: 32.51-32.94) in 2023, representing an overall decrease of 22% (AAPC -0.99). Men had higher AAMRs compared to women (45.0 [95% CI: 44.6-45.5] vs. 23.4 [95% CI: 23.2-23.7]). The highest mortality rate was observed among NH White individuals (AAMR: 34.8; 95% CI: 34.5-35.0), while the lowest was among NH Asian or Pacific Islanders (AAMR: 16.5; 95% CI: 15.6-17.5). Older adults exhibited the higher AAMRs (144.74; 95% CI: 143.60-145.88) compared to younger cohorts. An increased death burden was observed in non-metropolitan (AAMR: 37.1; 95% CI: 36.5-37.8) and Midwest regions (35.5; 95% CI: 34.9-36.0). The majority of the deaths occurred in inpatient facilities (34.7%). CONCLUSIONS: Although IHD-arrhythmia mortality declined between 1999 and 2023, substantial disparities persisted across demographic and geographic subgroups, highlighting the need for targeted public health interventions.
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Alam et al. (2026) conducted an observational in Ischemic heart disease and cardiac arrhythmias (n=1,795,918). Temporal trends (1999-2023) vs. 1999 baseline was evaluated on Age-adjusted mortality rate (AAMR) per 100,000 population (AAPC -0.99, 95% CI -1.78 to -0.20, p=0.0147). Between 1999 and 2023, the age-adjusted mortality rate for deaths involving both ischemic heart disease and cardiac arrhythmias in the US declined by 22%, from 41.97 to 32.73 per 100,000 population.
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