Abstract 4370886: Trends and Disparities in Ischemic Heart Disease and Sleep Apnea–Related Mortality in the United States (1999–2020): A CDC WONDER Study.

Background: Sleep apnea is a major risk factor for ischemic heart disease (IHD), and the two conditions are closely related. Our study aims to examine mortality trends related to IHD from 1999 to 2020, exploring potential contributions of sleep apnea to disparities across demographic and geographic subgroups. Method: Data related to mortality was extracted from CDC WONDER. The analysis of Multiple Cause of Death Files was conducted from 1999 to 2020 to identify fatalities associated with ischemic heart disease and sleep apnea. Crude rates and age-adjusted mortality rates (AAMRs) per 100,000 populations were calculated for variables including age, gender, race, and geographic regions. Joinpoint regression analysis was utilized to evaluate annual percent changes (APCs) and average annual percent changes (AAPCs). Results: Overall, the AAPC for IHD mortality was 9.15% (p<0.0001) from 1999 to 2020, with notable increases noted between 1999 and 2008 (APC=12.62%, 95% CI: 11.05–14.62) and 2018 and 2020 (APC=12.50%, 95% CI: 6.81–15.65). In comparison to females (8.99%, 95% CI: 8.57–9.78), males had a higher AAPC (9.24%, 95% CI: 8.78–9.83). There were clear racial inequalities, with Whites showing steady increases during the study period (AAPC=9.39%, 95% CI: 8.98–9.85) and Black or African Americans having a rapid increase in 2018–2020 (APC=23.54%, 95% CI: 14.05–29.43). Geographically, the Midwest reported the highest AAPC (10.07%, 95% CI: 9.37–11.86). Both AAMR and crude rates reflected these patterns, with crude rates rising from 0.36 in 1999 to 2.34 in 2020, mirroring the increase in AAMR. Older age groups and populations with higher sleep apnea prevalence exhibited elevated mortality burdens. Conclusion: The findings highlight persistent disparities in IHD mortality, potentially exacerbated by sleep apnea. These statistics underscore the growing impact of IHD and emphasize the need for targeted interventions addressing both IHD and sleep apnea to reduce persistent disparities.