A37-10 Widening Disparities in Heart Failure Mortality With Respiratory Comorbidity: A 22-year US Trends Analysis (1999-2020)

Abstract Background Heart failure (HF) mortality trends with respiratory disease as a contributing cause remain understudied. We analyzed 22-year US mortality data to quantify HF burden and identify disparities. Methods CDC Multiple Cause of Death data (1999-2020) were analyzed for deaths with HF as underlying cause and respiratory disease (ICD-10: J00-J98) as contributing cause. Annual percentage change (AAPC) was calculated using log-linear regression. Results Of 353,179 deaths (overall rate: 5.2/100,000), 56% were female (n = 198,608; AAPC: +0.12%) and 44% male (n = 154,571; AAPC: +0.78%). Overall AAPC was +0.89% (95% CI: 0.42-1.37%), with 27% mortality increase from 1999 (15,821 deaths) to 2020 (20,137 deaths). Age 85+ showed highest rates (142.4/100k) with declining AAPC (-1.45%). Regional analysis revealed South (AAPC: +0.42%) and Midwest (AAPC: +0.37%) with steeper increases than Northeast (+0.18%) and West (+0.35%). Hispanic populations (AAPC: +2.15%) showed greatest increase versus non-Hispanic (+0.25%). Disparities persisted across demographics: Black/African American (rate: 3.4/100k, AAPC: +1.23%) versus White (5.9/100k, AAPC: +0.32%). Rural areas (NonCore rate: 8.8/100k) exceeded urban centers (Large Central Metro: 4.0/100k) by 2.2-fold. American Indian/Alaska Native populations showed highest AAPC (+2.45%). Conclusion HF mortality with respiratory comorbidity increased significantly over two decades, with notable disparities by age, geography, race, and urbanization. Elderly, Hispanic, rural, and underrepresented racial/ethnic populations warrant targeted interventions. This abstract is funded by: NA