• Vardhmaan Jain, Abdul Mannan Khan Minhas, Robert W Ariss, Salik Nazir, Safi U Khan, Muhammad Shahzeb Khan, RifaiMahmoud AlMADepartment of Cardiology, Houston Methodist Hospital, Texas., Erin Michos, Anurag Mehta, Arman Qamar, Elizabeth M Vaughan, Laurence Sperling, and Salim S Virani.
• Department of Cardiology, Emory University, Atlanta, Ga.
• Am. J. Med. 2023 Jul 1; 136 (7): 659668.e7659-668.e7.

ObjectiveThe purpose of this research was to study the contemporary trends in cardiovascular disease (CVD) and diabetes mellitus (DM)-related mortality.MethodsWe used the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to identify adults ≥25 years old where both CVD and DM were listed as an underlying or contributing cause of death between 1999 and 2019. Crude and age-adjusted mortality rates per 100,000 population were determined.ResultsThe overall age-adjusted mortality rate was 99.18 in 1999 and 91.43 in 2019, with a recent increase from 2014-2019 (annual percent change 1.0; 95% confidence interval [CI], 0.3-1.6). Age-adjusted mortality rate was higher for males compared with females, with increasing mortality in males between 2014 and 2019 (annual percent change 1.5; 95% CI, 0.9-2.0). Age-adjusted mortality rate was highest for non-Hispanic Black adults and was ∼2-fold higher compared with non-Hispanic White adults. Young and middle-aged adults (25-69 years) had increasing age-adjusted mortality rates in recent years. There were significant urban-rural disparities, and age-adjusted mortality rates in rural counties increased from 2014 to 2019 (annual percent change 2.2; 95% CI, 1.5-2.9); states in the 90th percentile of mortality had age-adjusted mortality rates that were ∼2-fold higher than those in the bottom 10th percentile of mortality.ConclusionAfter an initial decrease in DM + CVD-related mortality for a decade, this trend has reversed, with increasing mortality from 2014 to 2019. Significant geographic and demographic disparities persist, requiring targeted health policy interventions to prevent the loss of years of progress.Copyright © 2023 Elsevier Inc. All rights reserved.

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