Abstract TP120: Trends In Stroke And Ischemic Heart Disease Related Mortality Among Older Adults Aged 45 Years And Older In The United States A 25 Year Retrospective Analysis 1999–2023

Introduction: Stroke and ischemic heart disease are leading causes of mortality among older adults in the United States, sharing common risk factors such as hypertension, diabetes, and smoking. Despite individual trend analysis, the combined burden of these conditions remains understudied. This retrospective study assesses mortality trends from 1999 to 2023, aiming to provide a comprehensive understanding of their joint impact. Methods: Death certificates from the CDC WONDER database were retrospectively analyzed using ICD-10 codes from 1999 to 2023 for ischemic heart disease and stroke-related mortality in adults aged 45-85+ years. Age-adjusted mortality rates (AAMR), annual percent change (APC), and confidence intervals (CI) were analyzed with JoinPoint regression and classified by year, sex, race, and geographic region (state, rural-urban, and census regions). Results: From 1999 to 2023, a total of 628,430 deaths in the United States were attributed to stroke and ischemic heart disease (IHD). The overall age-adjusted mortality rate (AAMR) decreased from 41.8 in 1999 to 10.5 in 2023. Trend analysis showed a significant decline in AAMR over the study period. In terms of gender, males consistently exhibited greater mortality rates compared to females, with an AAMR of (13.5 vs 8.1 in 2023). Ethnic variations were also evident, with African Americans registering the highest AAMR among all racial categories, having an AAMR of (15.1 in 2023), followed by Whites, then American Indian and Hispanic. Regional data based on census divisions showed the South having the highest AAMR. Urbanization analysis indicated that non-metro areas had higher AAMR as compared to metro regions (27.6 vs 21.4). Conclusion: Between 1999 and 2023, mortality from stroke and IHD in the United States declined, reflecting advances in prevention, treatment, and public health measures. However, men, Black or African American individuals, and residents of non-metropolitan areas continued to have higher death rates, indicating that disparities remain a significant public health concern.