Patterns and trends of mortality in patients with arrhythmia and cerebrovascular disease in the United States: a nationwide analysis of older adults

Abstract

Abstract Arrhythmias and cerebrovascular disease commonly coexist in older adults and are associated with increased mortality risk. However, population-level trends and demographic disparities in related deaths remain insufficiently characterized, necessitating large-scale analyses to better inform prevention, risk stratification, and healthcare planning. Data from CDC WONDER (1999–2023) identified U.S. mortality rates in adults aged (≥ 65 years) with arrhythmia (ICD-10: I47-I49) and cerebrovascular disease (ICD-10: I60-I69) among U.S. adults aged 65 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, race, urbanization and regions. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Between 1999 and 2023, a total of 733,476 deaths among older adults (≥ 65 years) were attributed to arrhythmias and cerebrovascular disease. The AAMRs exhibited an upward trend from 72.14 in 1999 to 74.62 in 2023 (AAPC: 0.055, 95% CI − 0.62 to 0.74; p 0.87) with a significant rise in AAMR from 65.51 in 2018 to 80.44 in 2021 (APC: 6.65; p 0.01). Men had higher AAMR than women during 1999–2023 with (73.97 to 81.27 vs. 70.22 to 69.2). NH White individuals had the highest AAMR in 2021 (87.43) with a total (631,483 deaths). The South recorded the most deaths (251,478) with a significant decline in AAMR from (70.36) in 2002 to (58.54) in 2008 (APC: − 2.89, 95% CI − 3.85 to − 1.92; p 0.004). Non-metropolitan areas had higher AAMR compared to metropolitan areas (73.62 vs. 64.71). For the place of death, the majority occurred in inpatient medical facilities (38.73%, 284,079 deaths). Mortality related to arrhythmias and cerebrovascular disease has increased in recent years among older adults. While women accounted for more deaths, men consistently had higher AAMRs. Higher mortality burden was also observed among NH White individuals, residents of the South, and urban populations, with most deaths occurring in inpatient medical facilities, highlighting the need for targeted interventions.