Trends in leukemia mortality among adults with cardiovascular disease in the United States, 1999–2024: An analysis of the CDC wonder database

Abstract Background: Leukemia remains a significant contributor to cancer-related mortality, with cardiovascular diseases (CVDs) commonly occurring as comorbidities that worsen patient outcomes. This study investigates trends in leukemia-related mortality among adults aged 45–85+ years with coexisting CVDs, aiming to evaluate the impact of CVDs on leukemia-associated deaths. Methods: Data were obtained from the CDC WONDER Multiple Causes of Death database for the years 1999 to 2024. We included death records listing leukemia as the underlying cause and CVDs as contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Joinpoint regression analysis was used to estimate annual percent changes (APCs). Results: A total of 157,301 deaths were identified among adults aged 45–85+. The overall AAMR declined from 5.5 in 1999 to 5.2 in 2024. A significant decrease occurred between 1999 and 2018 (APC: –0.76), followed by a notable increase from 2018 to 2024 (APC: 2.06). Males had higher AAMRs (7.0) compared to females (3.6). Older adults (≥65 years) exhibited a markedly higher AAMR (11.8) than middle-aged adults (45–64 years) (1.2). Non-Hispanic Whites had the highest AAMR (5.2) among racial/ethnic groups. Mortality rates were higher in non-metropolitan areas (5.2) compared to metropolitan areas (4.9), and highest in the Northeast region (5.6). Conclusion: Cardiovascular diseases appear to contribute significantly to leukemia-related mortality, particularly among older adults. Following a long-term decline, the recent uptick in AAMR underscores the need for integrated care strategies that address both leukemia and cardiovascular comorbidities.