Gupta Prashant S, Jetani Vatsalkumar, Desai Hardik D, Kyada Sumit, Sonani Shivani B, Gopi Gokul, Acharya Sankalp, Trivedi Yash, Kotnani Sandeep, Jain Hardik
Department of Medicine, Surat Municipal Institute of Medical Education and Research, Surat, IND.
Department of Medicine, Epsom and St Helier University Hospitals, London, GBR.
Cureus. 2025 Oct 23;17(10):e95210. doi: 10.7759/cureus.95210. eCollection 2025 Oct.
Introduction Cardiovascular disease (CVD) remains the leading cause of death in the United States, yet recent trends suggest widening disparities across race, sex, geography, and socioeconomic groups. Methods We conducted a retrospective, population-based trend analysis of mortality data from the National Vital Statistics System (NVSS), 2018-2023, accessed via the Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) online Database. Deaths with CVD (International Classification of Diseases, 10th revision (ICD-10): I00-I99) as the underlying cause were included. Mortality counts were stratified by race (15 single-race categories), sex, age, census region, 2013 urbanization level, Hispanic origin, and education. Cause-specific analyses covered major ICD-coded CVD subcategories. Annualized percentage change (APC) and 95% confidence intervals (CI) were estimated using log-linear regression of annual counts. Results Between 2018 and 2023, there were 5.4 million CVD deaths nationwide, rising from 868,662 in 2018 to 915,973 in 2023. The steepest increases occurred in Pacific Islander (6.7%/year), Vietnamese (6.2%), and Asian Indian (6.1%) populations, while Whites individuals (1.2%) and Japanese (0.3%) showed minimal changes. By cause, ischemic and hypertensive heart diseases accounted for the largest gains. Regional increases were most pronounced in the South and West, and rural non-core areas exhibited the fastest growth. Younger adults (25-44 years) in Black individuals, Asian Indian, and American Indian groups showed APCs exceeding 5%. Women generally experienced higher APCs than men. Disparities were amplified by Hispanic origin and lower educational attainment. Conclusions CVD mortality in the United States is once again rising, with young adults, women, minority populations, rural residents, Hispanics, and the less educated experiencing the sharpest increases. These findings reveal a reversal of prior gains and underscore the urgent need for equity-focused prevention and policy strategies.
引言 心血管疾病（CVD）仍然是美国的主要死因，但最近的趋势表明，在种族、性别、地理位置和社会经济群体之间，差距正在扩大。方法 我们对2018 - 2023年来自国家生命统计系统（NVSS）的死亡率数据进行了一项基于人群的回顾性趋势分析，数据通过疾病控制和预防中心（CDC）的广泛在线流行病学研究数据（WONDER）在线数据库获取。纳入以心血管疾病（国际疾病分类第10版（ICD - 10）：I00 - I99）作为根本死因的死亡病例。死亡人数按种族（15个单一种族类别）、性别、年龄、人口普查区域、2013年城市化水平、西班牙裔血统和教育程度进行分层。特定病因分析涵盖主要的ICD编码的心血管疾病子类别。使用年度计数的对数线性回归估计年化百分比变化（APC）和95%置信区间（CI）。结果 在2018年至2023年期间，全国有540万例心血管疾病死亡病例，从2018年的868,662例增至2023年的915,973例。增长最显著的是太平洋岛民（每年6.7%）、越南裔（6.2%）和印度裔（6.1%）人群，而白人（1.2%）和日本裔（0.3%）的变化最小。按病因来看，缺血性和高血压性心脏病的增长幅度最大。区域增长在南部和西部最为明显，农村非核心地区的增长速度最快。黑人、印度裔和美国印第安人群体中25 - 44岁的年轻人的年化百分比变化超过5%。女性的年化百分比变化通常高于男性。西班牙裔血统和较低的教育程度加剧了差距。结论 美国的心血管疾病死亡率再次上升，年轻人、女性、少数族裔、农村居民、西班牙裔和受教育程度较低者的增长最为显著。这些发现揭示了之前所取得进展的逆转，并凸显了迫切需要以公平为重点的预防和政策策略。
