National Trends & Disparities in Ischemic Heart Disease & Cardiac Arrhythmias Related Mortality in the United States From 1999 to 2024: A CDC Wonder Analysis

BACKGROUND: Ischemic heart disease and cardiac arrhythmias are major contributors to cardiovascular mortality in the United States. Understanding long-term national trends and demographic disparities is essential for guiding prevention strategies and public health policies. METHODS: A retrospective cross-sectional analysis was conducted using mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2024. Deaths in which IHD and a cardiac arrhythmia were both recorded were identified using ICD-10 codes. Crude mortality rates and age-adjusted mortality rates per 100,000 population were calculated. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Mortality patterns were further stratified by sex, race/ethnicity, age group, geographic region, and urbanization status. RESULTS: A total of 1 885 917 deaths were attributed to IHD and cardiac arrhythmias between 1999 and 2024. The overall AAMR declined from 41.97 in 1999 to 31.75 in 2024. Mortality decreased substantially from 1999 to 2009, stabilized through 2018, and increased sharply during 2018-2021 before declining again through 2024. The cumulative AAMR was 45.09 among males and 23.33 among females. Mortality varied across racial and ethnic groups, geographic regions, urbanization levels, and age groups. CONCLUSION: Although overall mortality related to IHD and cardiac arrhythmias has declined over the past two decades, demographic and geographic differences persist. The temporary rise during 2018-2021 coincided with the COVID-19 pandemic period and underscores the need for sustained prevention strategies and equitable healthcare access.