Death Rates from Obesity-Related Heart Disease Soared Nearly 200% Between 1990 and 2020, Researchers Report
AHA 2024. "...we did not anticipate this magnitude of increase in mortality," researchers said. They were also surprised by the population groups most affected.
Lead author
Courtesy of AHA
Mortality from obesity-related ischemic heart disease in the US increased by nearly 200% over the 2 decades between 1999 and 2020, with the most pronounced rise among men aged 55 to 64 years, Black adults, and residents of the Midwest and rural areas of the country.
The data, from a preliminary analysis of the CDC's WONDER (Wide-Ranging Online Data for Epidemiologic Research) database, are being presented at the American Heart Association’s Scientific Sessions 2024, November 16-18, in Chicago, IL.
Led by Aleenah Mohsin, MD, MBBS, a post-doctoral research fellow at Brown University in Providence, Rhode Island, investigators reported:
- A 5.03 (95% CI 4.5-5.4) annual percentage increase in the overall rate of obesity-related heart disease deaths
- An increase of 243% in age-adjusted death rate among men, from 2.1 deaths per 100 000 people in 1999 to 7.2 per 100 000 in 2020
- An increase of 165% in age-adjusted mortality among men aged 55 to 64 years, from 5.5 deaths per 100 000 people in 1999 to 14.6 deaths per 100 000 people in 2020
- An increase of 131% in the age adjusted mortality rate among women, from 1.6 deaths per 100 000 people in 1999 to 3.7 per 100 000 in 202
The age-adjusted death rate was highest among Black adults at 3.93 deaths per 100 000 people, according to the study abstract.1
“We did expect an increase in deaths related to obesity since the prevalence of obesity has been rising steadily for years. However, we did not anticipate this magnitude of increase in mortality, especially among middle-aged men,” Mohsin said in an AHA press statement. “The racial disparities, particularly the higher rates of death among Black individuals, were also striking and suggest that social and perhaps environmental factors may also be playing a significant role."
Wide Geographic Differences
When Moshin and her team examined the rise in deaths from obesity-related ischemic heart disease across the geographic US, they found the highest rates among residents of the Midwest where the age adjusted rate was 3.3 deaths per 100 000 people. The lowest rate, 2.8 deaths per 100 000 people, was observed in the Northeastern states. Western and southern states fell in between, with 3.1 deaths and 2.9 deaths, each per 100 000 people, respectively.
Among individual states, Vermont stood out dramatically in the Northeast, with the overall highest age-adjusted rate of death, at 10.4 per 100 000. At the lowest rate for age-adjusted mortality, Moshin et al reported the state of Alabama, at 1.5 deaths per 100 000.
Interestingly, the age adjusted mortality rate in 2020 was 4.0 per 100 000 people among those living in non-metropolitan areas compared to 2.9 per 100 000 among those in urban locations.
"The fact that Vermont, a state not typically associated with high obesity rates, had the highest death rate for obesity-related CVD death was unexpected and warrants further investigation, as does the finding that Alabama had the lowest death rate for obesity-related CVD deaths,” Moshin commented in the statement.
Moshin et al evaluated data for 226 267 deaths related to ischemic heart disease and obesity from 1999 to 2020 from the CDC WONDER database for people of all ages. The team reviewed both crude mortality rates and age-adjusted death rates per 100 000 individuals.
“The relative change in ischemic heart disease deaths related to obesity that was observed in this study between 1999 and 2020 was greater than the overall increase in obesity prevalence that we’ve seen in the United States, from about 30% to about 40% over this same time frame,” Sadiya S Khan, D, MSc, said in the press release. Khan is Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of cardiology, medical social sciences and preventive medicine (epidemiology) at Northwestern School of Medicine in Chicago. “There are a few potential reasons that could be the case," Kahn observed. "It may just be that people are more aware of obesity as a risk factor or are more likely to treat obesity, and, therefore, it is more likely to be included on death certificates, which were the basis of these data. The important thing is that we know we need to do more to identify, manage and treat obesity-related risk.”
“Our findings underscore the need to explore the underlying causes of these disparities, such as differences in health care access, socioeconomic factors and regional health policies,” lead author Moshin said in the statement. “Understanding these factors is the first step in identifying and designing more effective public health interventions.”
