Trends in mortality involving co-reported arrhythmia and dyslipidemia, 1999-2023: A Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research analysis with exploratory projections to 2035.
Khan M, Muhammad A, et al. • The Journal of international medical research • 2026
Mortality involving co-reported arrhythmia and dyslipidemia among US adults aged ≥65 years increased substantially from 4.96 to 47.9 per 100,000 between 1999 and 2023, with persistent demographic and geographic disparities and projected continued rise to 68.54 per 100,000 by 2035.
Key Findings
Results
Total deaths involving co-reported arrhythmia and dyslipidemia among US adults aged ≥65 years reached 246,710 over the 25-year study period from 1999 to 2023.
Data were drawn from the CDC WONDER multiple-cause mortality database using death certificate records.
Arrhythmia was identified using ICD-10 codes I44.0–I44.7, I45.0–I45.9, I47.0–I47.9, I48, and I49.0–I49.9.
Dyslipidemia was identified using ICD-10 code E78.
Both conditions had to appear among multiple causes of death on the same death certificate to be included.
Results
The age-adjusted mortality rate for co-reported arrhythmia and dyslipidemia increased nearly tenfold, from 4.96 per 100,000 in 1999 to 47.9 per 100,000 in 2023.
Rates are expressed as age-adjusted mortality rates per 100,000 population.
The study population was restricted to US adults aged ≥65 years.
This represents an approximately 865% increase over the 25-year study period.
Joinpoint regression was used to calculate annual percentage changes (APCs) in mortality trends.
Results
The largest single-period increase in mortality rate occurred between 2018 and 2021, with an annual percentage change of 17.88%.
The APC for the 2018–2021 period was 17.88% (95% CI: 14.79 to 21.04).
This period had the steepest rate of increase of any joinpoint segment identified in the analysis.
Joinpoint regression was the analytical method used to identify distinct trend segments.
Results
An exploratory ARIMA model projected the age-adjusted mortality rate to reach 68.54 per 100,000 by 2035.
The 95% prediction interval for the 2035 projection was 49.85 to 87.24 per 100,000.
The model used was an autoregressive integrated moving average (ARIMA) model.
The projections are described as 'exploratory' by the authors.
This projected rate would represent an additional ~43% increase above the 2023 rate of 47.9 per 100,000.
Results
Higher co-reported arrhythmia and dyslipidemia mortality rates were observed in males compared to females.
Sex was one of four stratification dimensions analyzed alongside race/ethnicity, census region, and urban-rural status.
Specific rate values by sex are not reported in the abstract but the disparity is noted as persistent.
Findings highlight the need for continued surveillance of sex-based disparities.
Results
Non-Hispanic White individuals had higher co-reported arrhythmia and dyslipidemia mortality rates compared to other racial/ethnic groups.
Race/ethnicity was one of four stratification dimensions examined.
The disparity in non-Hispanic White individuals was identified as a persistent pattern across the study period.
Specific rate values by racial/ethnic group are not provided in the abstract.
Results
Geographic disparities were identified, with higher mortality rates in the South and West census regions and in nonmetropolitan (rural) areas.
Analysis was stratified by four US census regions and by urban-rural status.
Nonmetropolitan areas showed higher rates than metropolitan areas.
The South and West regions showed higher rates compared to other census regions.
These geographic disparities were described as persistent across the study period.
Methods
The study used a retrospective, observational, population-based design drawing on death-certificate data from the CDC WONDER multiple-cause mortality database.
The study period spanned 1999 to 2023, covering 25 years of national mortality data.
Only adults aged ≥65 years were included in the analysis.
Multiple-cause mortality coding was used, meaning arrhythmia and dyslipidemia could appear as contributing (not necessarily underlying) causes of death.
Age-adjusted mortality rates per 100,000 were the primary outcome metric.
What This Means
This research suggests that deaths among older Americans (age 65 and over) that involved both irregular heart rhythms (arrhythmias) and high cholesterol or abnormal blood fats (dyslipidemia) rose dramatically over a 25-year period. Using national death certificate data, researchers found that the rate of such deaths jumped from about 5 per 100,000 people in 1999 to nearly 48 per 100,000 by 2023 — roughly a tenfold increase. The steepest rise happened between 2018 and 2021, when rates grew by nearly 18% per year. Statistical modeling projects this rate could reach about 69 per 100,000 by 2035 if current trends continue, though these are exploratory estimates.
The study also found consistent disparities in who was most affected. Men had higher rates than women, non-Hispanic White individuals had higher rates than other racial and ethnic groups, people living in rural (nonmetropolitan) areas were more affected than those in cities, and residents of the South and West regions of the United States had higher rates than those in other parts of the country. These patterns remained consistent across the full 25-year study period.
This research suggests that the combination of arrhythmia and dyslipidemia represents a growing public health concern among older adults in the United States, with uneven burdens across demographic and geographic groups. The findings point to the importance of ongoing monitoring and further research into why these deaths are increasing and why certain groups are disproportionately affected. Because this was a study of death certificates, it reflects cases where both conditions were noted on the same certificate but does not necessarily mean dyslipidemia directly caused the arrhythmia-related death.
Khan M, Muhammad A, Khatab A, Qasim S, Javed J, Khalid A, et al.. (2026). Trends in mortality involving co-reported arrhythmia and dyslipidemia, 1999-2023: A Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research analysis with exploratory projections to 2035.. The Journal of international medical research. https://doi.org/10.1177/03000605261488122