Trends and Disparities in Coronary Artery Disease and Obesity‐Related Mortality in the United States From 1999–2022

ABSTRACT Background Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity‐related mortality trends among adults in the United States stratified by age, sex, race and geographical location. Methods The CDC‐WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age‐adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis. Results From 1999 to 2022, a total of 273,761 CAD and obesity‐related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4–4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7–19.1). During the COVID‐19 pandemic (2020–2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non‐Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8–5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4–4.5). Conclusions We observed increasing trends in CAD and obesity‐related deaths throughout the study period reaching a peak during the COVID‐19 pandemic. Obesity is a key risk factor for coronary artery disease (CAD) and can lead to increased risk of mortality. This study explored the mortality trends in individuals with concomitant CAD and obesity over two decades. The mortality rate of CAD and obesity gradually increased from 1999 to 2018, and a peak was observed during the COVID‐19 pandemic when the mortality rates almost doubled. Males had an almost double age‐adjusted mortality rate (AAMR) that of females. Rural areas had higher AAMR than urban areas.