Trends in obesity‐related ischemic heart disease mortality among adults in the United States from 1999 to 2020

Obesity is a critical risk factor for ischemic heart disease (IHD), affecting 42% of the U.S. population. This study examines trends in obesity-related IHD mortality among U.S. adults aged 25 and older from 1999 to 2020, using the CDC WONDER database. We analyzed IHD as the primary cause and obesity as a contributing factor, calculating age-adjusted (AAMRs) and crude mortality rates (CMRs) per 100,000 individuals. Joinpoint regression assessed annual percent changes (APC), stratifying by race, sex, age, and region. From 1999 to 2020, 139,644 obesity-related IHD deaths were recorded. AAMR rose from 1.92 to 4.69 per 100,000. Rates were higher in men (3.79) than women (2.10), with Black Americans showing the highest AAMR (4.07). Older adults (65+) had the highest CMR (5.73). Nonmetropolitan areas exhibited higher AAMRs (3.47) than metropolitan regions (2.78). States with the highest mortality included Vermont, Oklahoma, Wyoming, Wisconsin and Iowa while Alabama, Virginia, Massachusetts, Connecticut and Georgia had the lowest. The findings indicate a 2.5-fold increase in obesity-related IHD mortality, highlighting the need for targeted public health interventions and further research to address this growing public health concern. Obesity is a growing public health crisis, affecting over 100 million adults in the U.S. It significantly increases the risk of ischemic heart disease (IHD), the leading cause of death among adults. This study analyzed death records from 1999 to 2020 to track trends in obesity-related IHD deaths. Findings show that obesity-related IHD mortality rates more than doubled over two decades, with a sharper increase after 2018. Men had nearly double the death rates of women, and Black Americans had the highest mortality rates among all racial groups. Older adults and people living in rural areas were also at greater risk. The COVID-19 pandemic may have worsened trends due to reduced physical activity, stress, and limited healthcare access. To address this crisis, public health efforts should focus on improving access to healthy food, encouraging physical activity, and expanding healthcare services in high-risk areas. Despite medical advancements, obesity-related heart disease deaths continue to rise, highlighting the urgent need for prevention and policy interventions targeting at-risk populations.