Two decades of lipid disorder–associated mortality in United States adults: implications for cardiovascular disease prevention and metabolic health

Lipid disorders significantly contribute to cardiovascular mortality, but national trends and disparities in lipid disorder-related deaths remain underexplored. This study sought to analyze mortality trends related to lipid disorders across different demographic groups and geographic regions within the adult population of the United States. We examined death certificates from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research database to identify adults in whom lipid disorders were recorded as an underlying or contributing cause of death from 1999 to 2020. Age-adjusted mortality rates per 100,000 individuals and annual percent change were calculated and analyzed based on year, sex, ten-year age groups, race/ethnicity, and geographic region. Between 1999 and 2020, a total of 1,178,374 deaths among adults aged ≥ 25 years were attributed to lipid disorders. The overall age-adjusted mortality rates showed a significant increase, rising from 8.9 in 1999 to 21.7 in 2007, followed by a gradual but sustained rise to 32.2 in 2018, and a more pronounced increase to 44.2 in 2020. Throughout the study period, men consistently exhibited higher age-adjusted mortality rates than women, with rates increasing from 10.8 in men and 7.2 in women in 1999 to 54.6 and 35.6, respectively, in 2020. The highest age-adjusted mortality rates were observed among individuals aged ≥ 85 years (290) and Black or African American individuals (25.3). Geographically, Vermont (44.9) and the Western region (27.4) reported the highest age-adjusted mortality rates. Additionally, mortality rates were consistently higher in non-metropolitan areas (27.2) compared to metropolitan areas (24.7). Mortality associated with lipid disorders has exhibited a continuous upward trend through 2020, with marked demographic and geographic disparities. These findings indicate emerging gaps in cardiometabolic risk management and highlight the need for improved, targeted strategies to reduce lipid disorder–related and downstream cardiovascular mortality in high-risk United States populations. Not applicable.