Temporal Trends of Mortality Associated With Coronary Artery Disease–Chronic Obstructive Pulmonary Disease Comorbidity in the United States

Coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) exhibit a significant bidirectional relationship, whereby the presence of 1 condition significantly increases the risk of developing the other, resulting in their frequent co-occurrence. We seek to assess demographic and geographic disparities and examine mortality trends from CAD and COPD in the United States from 1999 to 2023. We retrieved mortality data for patients with CAD and COPD from the Centres for Disease Control and Prevention, Wide-Ranging Online Data for Epidemiologic Research Multiple Cause of Death database from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, and trends were analyzed using the Joinpoint regression model to estimate the annual percent change (APC) in AAMR. Mortality data were stratified by age, sex, race/ethnicity, urbanization, and Census regions. A total of 1,471,054 mortalities showed the existence of CAD and COPD on death certification. The AAMR decreased from 61.1 to 41.8 from 1999 to 2023. The AAMR declined sharply until 2018 (APC -1.9), followed by a significant incline till 2021 (APC 4), after which it continued to decrease significantly until 2023 (APC -6.12). AAMR was twofold greater in males (71.7) than in females (34.3). Among races/ethnicities, non-Hispanic Whites (52.7) had the top AAMR. Mortality rates were 13 times greater among older adults than among middle-aged adults. From geographics, nonmetropolitan areas (63.3) and the Midwest region (55.2) had the highest AAMRs. These disparities across demographic and geographical variables necessitate appropriate resource allocation and targeted interventions to reduce the CAD-COPD mortality burden.