{
  "abstract": "Introduction Ischemic heart disease (IHD) and sudden cardiac death (SCD) are leading causes of mortality among older adults in the United States. This study evaluates long-term mortality trends and demographic and geographic disparities among adults aged ≥65 years from 1999 to 2023.Methods We conducted a retrospective population-based study using the CDC WONDER Multiple Cause of Death database from 1999 to 2023. Deaths were extracted using a multiple cause-of-death approach with ICD-10 codes I20–I25 for ischemic heart disease and I46.1, I46.9, and R96 for sudden cardiac death. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by age group, sex, race/ethnicity, U.S. Census region, and urbanization status. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs).Results Overall mortality from IHD and SCD among adults aged ≥65 years declined significantly from 1999 to 2023 (AAPC: −3.72%; 95% CI: −3.92 to −3.50). Trend analysis identified multiple inflection points, including a modest increase during 2017–2021 (APC: 1.92%; 95% CI: 0.38 to 4.51), followed by a sharp decline during 2021–2023 (APC: −10.76%; 95% CI: −13.50 to −6.78).All age groups experienced significant long-term declines, with the steepest reduction observed among adults aged ≥85 years (AAPC: −4.04%; 95% CI: −4.35 to −3.75). Females exhibited a greater overall decline than males (AAPC: −4.30% vs. −3.59%). Analysis by race and ethnicity revealed that Hispanic or Latino individuals experienced the largest decline (AAPC: −4.50%; 95% CI: −5.22 to −3.72), whereas White individuals exhibited smaller reductions (AAPC: −3.53%; 95% CI: −3.81 to −3.30). Black or African American adults showed substantial temporal variability, with a pronounced decline observed during 2021–2023 (APC: −13.67%; 95% CI: −20.13 to −5.68).Mortality rates declined across all census regions, with the Midwest experiencing the greatest reduction (AAPC: −3.87%) and the West the smallest (AAPC: −2.62%). Although non-metropolitan areas exhibited higher mortality rates, their declines were less pronounced compared to metropolitan areas (AAPC: −2.26% vs. −3.44%).Conclusion Despite substantial overall reductions in mortality, significant demographic and geographic disparities persist. Temporary upward shifts in mortality demonstrate persistent vulnerability among elderly persons, calling for focused cardiovascular prevention and provision of care at vulnerable stages and equitable distribution of care among high-risk groups.Abstract 250 Figure 1Age-adjusted mortality rates from ischemic heart disease (IHD) and sudden cardiac death (SCD) in the United States by age group, 1999–2023.Abstract 250 Figure 2Age-adjusted mortality rates from ischemic heart disease (IHD) and sudden cardiac death (SCD) in the United States by sex, 1999–2023.",
  "authors": [
    {
      "affiliations": [
        "Foundation University Medical College, Islamabad, Pakistan"
      ],
      "name": "Haider Imran"
    },
    {
      "affiliations": [
        "University Medical and Dental College, Faisalabad, Pakistan"
      ],
      "name": "Mahrukh Mahrukh"
    },
    {
      "affiliations": [
        "CMH Multan Institute of Medical Sciences, Multan, Pakistan"
      ],
      "name": "Muhammad Usama Saeed"
    },
    {
      "affiliations": [
        "Services Institute of Medical Sciences, Lahore, Pakistan"
      ],
      "name": "Huzaifa Sabir Nawaz"
    },
    {
      "affiliations": [
        "Foundation University Medical College, Islamabad, Pakistan"
      ],
      "name": "Izza Zahra"
    },
    {
      "affiliations": [
        "University Medical and Dental College, Faisalabad, Pakistan"
      ],
      "name": "Shiza Kashif"
    },
    {
      "affiliations": [
        "University Medical and Dental College, Faisalabad, Pakistan"
      ],
      "name": "Zainab Attiq"
    },
    {
      "affiliations": [
        "University Medical and Dental College, Faisalabad, Pakistan"
      ],
      "name": "Sahar Zafar"
    },
    {
      "affiliations": [
        "Khyber Medical University, Peshawar, Pakistan"
      ],
      "name": "Haseeb Sadaqat"
    },
    {
      "affiliations": [
        "Fatima Jinnah Medical University, Lahore, Pakistan"
      ],
      "name": "Tuba Shukoor"
    },
    {
      "affiliations": [
        "Saidu Medical College, Swat, Pakistan"
      ],
      "name": "Maria Sadaqat"
    },
    {
      "affiliations": [
        "Foundation University Medical College, Islamabad, Pakistan"
      ],
      "name": "Visha Zafar"
    }
  ],
  "title": "250 Trends and disparities in mortality from ischemic heart disease and sudden cardiac death among older adults (≥65 years) in the United States, 1999–2023",
  "uid": "d255b1d2-df61-56ae-a9cb-1190a0a539fa"
}