Trends and disparities in acute myocardial infarction mortality with contributing hyperlipidemia in the United States, 1999-2024.
TL;DR
The rate of AMI deaths in which hyperlipidemia was documented as contributing condition increased significantly over the 26-year study period, with steepest trends observed in males, NH Black, older aged, the southern region, and rural areas.
Abstract
Background
AND
Aim
Acute myocardial infarction (AMI) remains a leading cause of cardiovascular mortality, and hyperlipidemia is a major modifiable risk factor. However, long-term national trends and disparities in AMI-related mortality with contributing hyperlipidemia have not been well defined.
Methods
AND
Results
Using the CDC WONDER database (1999-2024), AMI-related deaths among U.S. adults with hyperlipidemia documented as a contributing condition were identified using ICD-10 codes. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 were calculated. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Analyses were stratified by sex, race and ethnicity, age group, census region, urban-rural status, and place of death. A total of 279,210 deaths were identified in which AMI was recorded as the underlying cause and hyperlipidemia was documented as a contributing condition. The overall AAMR increased from 2.89 in 1999 to 5.54 in 2024 (AAPC: 2.46; 95% CI: 2.25-2.70; p < 0.001). Mortality was higher among males than females (overall AAMR: 6.33 vs. 3.23), with a greater increase observed in males over time. Non-Hispanic (NH) Black individuals experienced the steepest rise in mortality, while NH White individuals had the highest overall AAMR. Adults aged ≥ 65 years accounted for the majority of deaths and demonstrated the highest mortality rates. Regionally, the Midwest had the highest overall AAMR, whereas the South showed the greatest temporal increase. Mortality was higher in non-metropolitan compared with metropolitan areas, and most deaths occurred at home or in medical facilities.
Conclusion
The rate of AMI deaths in which hyperlipidemia was documented as contributing condition increased significantly over the 26-year study period, with steepest trends observed in males, NH Black, older aged, the southern region, and rural areas.