Mortality rates from stroke associated with heart failure in older U.S. adults declined from 57.63 to 29.77 per 100,000 from 1999 to 2023, with recent rebounds post-2018.
Mortality from stroke associated with heart failure in older U.S. adults declined overall from 1999 to 2023, but recent increases post-2018 highlight the need for targeted prevention strategies.
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Background: Stroke associated with heart failure (HF) remains a significant cause of mortality in the older U.S. adults. We examined long-term trends in age adjusted mortality rates (AAMRs) from 1999 to 2023 stratified by demographic and geographic factors. Hypothesis: We hypothesize that mortality from stroke associated with heart failure in older U.S. adults declined substantially from 1999 to 2023, but recent rebounds emerged after 2018. Methods: Mortality data of adults ≥65 years with stroke associated with HF were extracted from CDC wonder database. AAMRs (per 100,000) were calculated using U.S. standard population weights and ICD-10 codes for stroke (I60–I64) and heart failure (I50). Trends analyzed using join point regression to estimate average annual percent change (AAPC) with 95% confidence intervals (CIs). A p-value of <0.05 was considered as significant. Results: From 1999-2023, 366,184 deaths occurred among older U.S. adults with stroke associated with HF; most were in medical facilities (40.1%). The national (AAMR) was 57.63 per 100,000 in 1999, declining overall to 29.77 in 2023, with a steep initial drop, slower mid-period decline, and rebound in the late 2010s to early 2020s and (AAPC: -2.86). Men consistently had higher AAMRs than women (36.93 vs. 33.26 overall) and (AAPC: -3.18 vs -2.34). Among women, rates fell initially till 2011, then declined more slowly to 2018, and rose in 2021, then fell again. For men, rates dropped steeply until 2009, slowed in the following years, rose again by 2021, and then slightly declined. By race/ethnicity, NH Black individuals had the highest overall AAMR (46.53) with steep declines and increases after 2018. Asian/Pacific Islanders had the lowest (23.29, AAPC: -3.914) with later fluctuations. Regionally, the Midwest had the highest and Northeast the lowest rates. Non-metropolitan areas had higher rates than metropolitan areas (AAPC: -3.11 vs - 3.24). State-level AAMRs ranged from Mississippi (68.43) to Arizona (15.08). Conclusion: From 1999-2023, mortality from stroke associated with HF in older adults declined with variations by sex, race/ethnicity, region and urbanization. Recent rise in multiple subgroups post 2018 warrants targeted prevention strategies.
Jairamani et al. (Thu,) reported a other. Mortality rates from stroke associated with heart failure in older U.S. adults declined from 57.63 to 29.77 per 100,000 from 1999 to 2023, with recent rebounds post-2018.