Trends and disparities in deaths involving atherosclerotic cardiovascular disease and stroke-related conditions among U.S. adults, 1999–2025

作者：Muhammad Atif Mazhar, Abdal Ahmad, Vishan Das, Danyal Ahmad, Kaneez Fatima, M Mukhlis, Eshal Atif, Zubair Ahmed, Sadia Qazi · 发表于：Frontiers in Cardiovascular Medicine · 年份：2026 · DOI：10.3389/fcvm.2026.1851946 · 研究领域：COVID-19 and healthcare impacts、Cerebrovascular and Carotid Artery Diseases、Atherosclerosis and Cardiovascular Diseases

Background ASCVD and stroke remain leading causes of death in the United States, sharing overlapping risk factors and clinical consequences. Long-term declines in vascular mortality have slowed while disparities persist. We evaluated national trends and disparities in mortality involving coexisting ASCVD- and stroke-related conditions among U.S. adults from 1999 to 2025. Methods We performed a retrospective population-based study using the CDC WONDER Multiple Cause of Death database. Adults aged ≥25 years were included. Deaths were identified when prespecified ASCVD-related and stroke-related ICD-10 codes were both documented on the same death certificate, whether as underlying or contributing causes. The outcome represents a death-certificate-defined mortality phenotype rather than clinically adjudicated concurrent disease. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Trends were assessed overall and by sex, age group, race/ethnicity, census region, urbanization, and state. Urbanization analyses were restricted to 1999–2020. Sensitivity analyses included restriction to atherosclerotic-specific codes (I25.x) and exclusion of provisional 2025 data. Results A total of 876,383 deaths were identified. Overall average AAMR was 15.01 per 100,000. Mortality declined from 26.82 in 1999 to 10.91 per 100,000 in 2025, with an AAPC of −3.53% (95% CI, −4.27 to −2.78; p < 0.001). After sustained declines through 2018, AAMR...