Demographic and Regional Trends of Cardiovascular Diseases and Diabetes Mellitus-Related Mortality in the United States From 1999 to 2019

Vardhmaan Jain, Abdul Mannan Khan Minhas, Robert W. Ariss, Salik Nazir, Safi U. Khan, Muhammad Shahzeb Khan, Mahmoud Al Rifai, Erin Michos, Anurag Mehta, Arman Qamar, Elizabeth M. Vaughan, Laurence Sperling, Salim S. Virani

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: The purpose of this research was to study the contemporary trends in cardiovascular disease (CVD) and diabetes mellitus (DM)-related mortality. Methods: We 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. Results: The 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. Conclusion: After 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.

Original languageEnglish (US)
Pages (from-to)659-668.e7
JournalAmerican Journal of Medicine
Issue number7
StatePublished - Jul 2023


  • Cardiovascular diseases
  • Diabetes mellitus
  • Health care disparities
  • Mortality trends

ASJC Scopus subject areas

  • General Medicine


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