Obesity-Related Heart Disease Deaths Rose Roughly 180% Since 1999

An analysis of data from the US Centers for Disease Control and Prevention (CDC) WONDER Database is shedding light on just how impactful the rising obesity epidemic has been on rate of mortality within the US.

The study, which was presented at the American Heart Association (AHA) Annual Scientific Sessions 2024, found the rate of ischemic heart disease related to obesity increased by roughly 180% from 1999 to 2020, with the greatest increases seen among middle-aged men aged 55 to 64 years, Black adults and people who live in the Midwestern states and non-metropolitan areas in the US.¹

“Obesity is a serious risk factor for ischemic heart disease, and this risk is going up at an alarming rate along with the increasing prevalence of obesity,” said lead investigator Aleenah Mohsin, MD, MBBS, a post-doctoral research fellow at Brown University in Providence, Rhode Island.¹ “It is important for everyone, particularly people in high-risk groups, to take steps to manage their weight and reduce their risk of heart disease. Lifestyle changes are key, such as eating healthier, exercising regularly and working with health care professionals to monitor heart health.”

Since the turn of the century, US public health and health systems across the globe have been made to grapple with a growing obesity epidemic. Although the rising rates of obesity, particularly, within the US have been well-documented, much less research has been performed to better understand the impact on obesity-related mortality.^1,2

With this in mind, Mohsin and an international team of investigators launched the current study to evaluate trends in obesity-related ischemic heart disease, with additional interest in assessing racial, local, regional, age and gender-wise differences in this trend. To do so, investigators designed their study as an analysis of data from 1999 to 2020 within the CDC’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database.¹

The primary outcome of interest for the investigators’ analysis was crude and age-adjusted mortality rates (AAMR) per 100,000 individuals. investigators noted plans to calculate average annual percentage change (AAPC) for AAMRs using joinpoint regression analysis.¹

During the study period, investigators identified a total of 226,267 deaths occurred due to obesity-related ischemic heart disease. Analysis of trends revealed a uniform rise in AAMR from 1999 to 2020, with an AAPC of 5.03 (95% CI, 4.5 to 5.4).¹

Subgroup analyses suggested males (3.9) had a greater AAMR than females (2.2) and also experienced a more prominent incline in mortality rates (AAPC, 5.11; 95% CI, 4.1 to 6.1), during the study, particularly among males aged 55 to 64 years (AAMR, 8.5). Investigators also pointed out the greatest rise in AAMR was observed among Black adults (AAMR, 3.93).¹

Additionally, investigators called attention to significant variation by geographical location, with the greatest AAMR observed among those in Midwest states (AAMR, 3.3) followed by Western states, Southern States, and Northeastern states. When examining specific states instead of regions, the greatest AAMR was observed for Vermont (AAMR, 10.4) and Alabama (AAMR, 1.5) had the lowest.¹

“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,” said Sadiya Khan, who was not involved in the study, but serves as an associate professor of cardiology, medical social sciences and preventive medicine (epidemiology) at Northwestern School of Medicine as well as chair of the writing group for the AHA’s PREVENT equations.² “There are a few potential reasons that could be the case. 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.”

References:

1. Shaukat MT, Mohsin A, CHaudhary AJ, et al. Trends in Obesity-related Ischemic Heart Disease Mortality in the United States from 1999 to 2020. Paper presented at: American Heart Association Scientific Sessions 2024; November 15 - 18; Chicago, Il. Accessed: November 16, 2024.
2. American Heart Association. Obesity-related heart disease deaths increased in the U.S. over the past two decades. American Heart Association Newsroom. November 11, 2024. Accessed November 17, 2024. https://newsroom.heart.org/news/obesity-related-heart-disease-deaths-increased-in-the-u-s-over-the-past-two-decades.