Kwaah Patrick A, Mensah Samuel A, Carboo Abraham, Appah Grace, Rashid Hamza A, Djanie Stephen N, Kwakye Ama O, Agyemang Emmanuel A, Kekrebesi Joseph S, Donaldy Webster, Nti Patrick, Sarpong Christopher B
Department of Internal Medicine, Yale School of Medicine, Waterbury, Connecticut, United States of America.
Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States of America.
PLOS Glob Public Health. 2025 Sep 11;5(9):e0004705. doi: 10.1371/journal.pgph.0004705. eCollection 2025.
Chronic ischemic heart disease (CIHD) is one of the leading causes of significant morbidity and mortality in the United States. While previous studies have reported an overall decline in ischemic heart disease mortality, contemporary trends in CIHD-related mortality across sex, race, and urbanization status remain inadequately explored. We examined CIHD-related mortality trends in the U.S. from 1999 to 2019.We analyzed mortality data from the CDC WONDER database using CIHD ICD-10 codes. Age-adjusted mortality rates (AAMR) were calculated per 100,000 individuals. Trends were analyzed using Joinpoint regression to determine annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence intervals. Over two decades, 5,729,619 CIHD-related deaths were recorded. AAMR declined from 185.6 (95% CI: 184.9-186.2) per 100,000 in 1999 to 94.9 (95% CI: 94.5-95.3) per 100,000 in 2019. There were, however, disparities among demographic groups. Males had consistently higher mortality than females (overall AAMR: 167.2 vs. 96.0 per 100,000), and among racial groups, non-Hispanic Black individuals had the highest AAMR (148.3 per 100,000. Initially, urban areas had higher mortality than rural areas, but by 2019, their AAMRs converged (urban: 94.7 [95% CI: 94.3-95.1]; rural: 96.1 [95% CI: 95.1-97.0] per 100,000). CIHD mortality has declined across all demographics over the last two decades; however, disparities persist, particularly among males and non-Hispanic Black individuals. While rural and urban populations had differing mortality rates initially, they showed similar AAMR by the end of the study period. Focused public health interventions are crucial to addressing these inequities.
慢性缺血性心脏病（CIHD）是美国导致严重发病和死亡的主要原因之一。虽然先前的研究报告了缺血性心脏病死亡率的总体下降，但CIHD相关死亡率在性别、种族和城市化状况方面的当代趋势仍未得到充分探讨。我们研究了1999年至2019年美国CIHD相关的死亡率趋势。我们使用CIHD ICD - 10编码分析了疾病控制与预防中心（CDC）WONDER数据库中的死亡率数据。按每10万人计算年龄调整死亡率（AAMR）。使用Joinpoint回归分析趋势，以确定年度百分比变化（APC）和平均年度百分比变化（AAPC）以及95%置信区间。在二十多年间，记录了5729619例与CIHD相关的死亡。AAMR从1999年的每10万人185.6（95%置信区间：184.9 - 186.2）降至2019年的每10万人94.9（95%置信区间：94.5 - 95.3）。然而，不同人口群体之间存在差异。男性的死亡率一直高于女性（总体AAMR：每10万人167.2对96.0），在种族群体中，非西班牙裔黑人的AAMR最高（每10万人148.3）。最初，城市地区的死亡率高于农村地区，但到2019年，它们的AAMR趋于一致（城市：每10万人94.7 [95%置信区间：94.3 - 95.1]；农村：每10万人96.1 [95%置信区间：95.1 - 97.0]）。在过去二十年中，所有人口群体的CIHD死亡率都有所下降；然而，差异仍然存在，特别是在男性和非西班牙裔黑人中。虽然农村和城市人口最初的死亡率不同，但在研究期结束时它们的AAMR相似。有针对性的公共卫生干预对于解决这些不平等问题至关重要。
