What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular mortality with obesity (n=363203). Primary outcome: Age-adjusted mortality rates (AAMR) per 100,000 population (AAPC +4.88%).

What does this research mean for the field?

Cardiovascular mortality among US adults with obesity tripled from 1999 to 2023, with significant disparities across demographic and geographic groups. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 12, 2026

Temporal Trends and Disparities in Cardiovascular Mortality Among Adults With Obesity in the United States From 1999 to 2023

Key Result

Cardiovascular mortality among US adults with obesity tripled from 1999 to 2023, increasing from 3.40 to 10.34 per 100,000 population (AAPC +4.88%).

Key Points

Examine patterns of cardiovascular mortality among adults with obesity in the United States from 1999 to 2023.
Analyzed CDC WONDER Multiple Cause of Death data for adults aged ≥ 25 years
Calculated age-adjusted mortality rates per 100,000 population
Utilized joinpoint regression analysis to identify temporal trends across demographics
Cardiovascular mortality among adults with obesity tripled from 3.40 to 10.34 per 100,000
Steepest increase seen in ages 75–84 with an annual percent change of +5.66%
Non-Hispanic Black adults had the highest age-adjusted mortality rate at 18.30 per 100,000 in 2023

Study Design

Type

Observational (n=363,203)

Structured PICO

Population

Adults aged ≥ 25 years in the United States (1999–2023) where cardiovascular disease was the underlying cause of death and obesity was a contributing cause (n=363,203 deaths).

Outcome

Age-adjusted mortality rates (AAMR) per 100,000 populationhard clinical

Cardiovascular mortality among US adults with obesity tripled between 1999 and 2023, with widening disparities disproportionately affecting men, older adults, and Non-Hispanic Black populations.

Main Result

Effect estimate: AAPC +4.88%

Abstract

ABSTRACT Objective Obesity prevalence in the United States has surged dramatically, yet comprehensive analysis of cardiovascular mortality patterns among adults with obesity remains lacking. Methods We analyzed CDC WONDER Multiple Cause of Death data for adults aged ≥ 25 years in the United States (1999–2023), identifying deaths where cardiovascular disease was the underlying cause and obesity was a contributing cause. Age‐adjusted mortality rates (AAMR) per 100,000 population were calculated. Joinpoint regression analysis identified temporal trends stratified by sex, age, race/ethnicity, and geographic region. Results Among 363,203 cardiovascular deaths, AAMR tripled from 3.40 to 10.34 per 100,000 (average annual percent change AAPC: +4.88%). Three distinct phases emerged: steady increase (1999–2018), pandemic acceleration (2018–2021, 12.22% annual increase), and recent decline (2021–2023). Men had higher mortality than women (12.69 vs. 8.06 per 100,000 in 2023). The 75–84 years group showed the steepest increase (AAPC: +5.66%). Non‐Hispanic Black adults maintained the highest AAMR (18.30 per 100,000 in 2023). The South transformed from lowest to highest regional burden (AAPC: +5.52%). The disease spectrum shifted toward atherosclerotic and hypertensive conditions. Conclusions Cardiovascular mortality among US adults with obesity tripled over 25 years, with widening disparities across demographic and geographic groups, necessitating equitable public health interventions targeting high‐risk populations. image

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