Trends and disparities in arrhythmia-related deaths among older adults in the United States, 1999–2020

Abstract

This study examines mortality trends and disparities in arrhythmia-related deaths among older adults in the United States from 1999 to 2020. Utilizing mortality data from the CDC WONDER database, we analyzed over 3 million arrhythmia-related deaths identified by ICD-10 codes I47.0-I49.9. The study computed age-standardized mortality rates (ASMR) to assess trends across demographic groups and geographical locations. Statistical techniques, including Joinpoint regression analysis, were employed to examine demographic and regional trends in mortality rates. The overall ASMR for arrhythmia-related deaths increased from 38.0 per 10,000 in 1999 to 47.0 in 2020. The trend showed a decline from 1999 to 2009 (APC: −0.9), followed by increases from 2009 to 2018 (APC: 1.5) and a significant rise from 2018 to 2020 (APC: 7.4). Men had higher ASMRs than women (45.2 vs. 33.0), with significant increases observed in both sexes in recent years. Racial disparities were evident, with Non-Hispanic (NH) Whites having the highest ASMR (40.5), followed by NH Blacks (31.1), NH American Indians/Alaska Natives (28.3), Hispanics (22.7), and NH Asians/Pacific Islanders (19.7). Geographic disparities were also prominent, with Vermont exhibiting the highest ASMR (55.8) and Nevada the lowest (24.9). The Midwest region had the highest regional ASMR (41.2), while nonmetropolitan areas consistently showed higher rates than metropolitan areas (42.1 vs. 37.2). These findings highlight significant disparities in arrhythmia-related mortality, underscoring the need for targeted interventions to address these public health challenges.