Burden of coronary heart disease and hepatocellular carcinoma mortality among U.S. adults: A 25-year analysis.

e16492 Background: Coronary heart disease (CHD) and hepatocellular carcinoma (HCC) are leading causes of morbidity and mortality worldwide. Metabolic dysfunction and shared risk factors link these conditions, yet temporal trends and disparities in mortality among adults with both diseases remain poorly understood. Methods: We conducted a population-based analysis using CDC WONDER Multiple Cause of Death (MCOD) data from 1999–2023 in adults aged ≥45 years with CHD (ICD-10: I20–I25) and HCC (ICD-10: C22.0) listed as underlying or contributing causes of death. Age-adjusted (AAMR) and crude mortality rates (CMR) per 100,000 were calculated. Trends were analyzed by age, sex, region, urbanization, and place of death. Annual percent changes (APCs) with 95% confidence intervals (CI) were estimated using Joinpoint regression. Results: Among 11,767 decedents, 3,746 deaths occurred in inpatient settings. Overall AAMR rose steadily from 2013-2023 (APC: +4.88*,95%CI: 4.08,5.68,p < 0.05). Middle-aged adults (45-64 years) experienced a sharp early increase (1999-2007; APC: +15.55, 95% CI: -7.02 to -24.78; p < 0.05), while AAMR declined in this group from 2015-2023 (APC: -5.24, 95% CI: -9.43 to -0.85; p < 0.05). Females showed a significant rise from 2012-2023 (APC: +6.51, 95% CI: 4.28 to 8.79; p < 0.05). Regionally, the Midwest demonstrated increasing mortality (2015-2023; APC: +6.53, 95% CI: 3.89–9.21; p < 0.05). Both metropolitan (2011-2020; APC: +4.37, 95% CI: 2.65-6.12; p < 0.05) and non-metropolitan areas (2016-2020; APC: +10.22, 95% CI: 1.66 to 19.50; p < 0.05) experienced rising AAMRs. The highest CMR in 2023 was among adults ≥65 years (1.29; 95% CI: 1.20 to 1.39). Conclusions: Mortality from CHD and HCC continues to rise, particularly among females, older adults, and residents of the Midwest and both metropolitan and rural areas. These trends underscore the urgent need for integrated national screening programs, targeted public health interventions, and research to address underlying disparities.