Patterns in mortality associated with heart failure and lung cancer among older adults in the United States: An analysis of 20 years

Background: Despite an established association between heart failure (HF) and lung cancer (LC), there is limited evidence available regarding mortality patterns among the older (≥65 years) population in the United States.

Methods: The mortality data, spanning 1999 to 2019, was surveyed using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database with HF and LC identified as underlying or contributing causes of death. Crude and age-adjusted mortality rates (AAMR) were calculated per 100,000 individuals. Joinpoint regression was applied to establish annual percent changes (APCs) for the trends in years, demographics (sex, race), and geographical regions.

Results: Between 1999 and 2019, the overall AAMR slightly decreased from 13.0 to 11.4. However, the AAMRs significantly increased (APC: 6.37; 95 % CI: 3.39 to 8.23) from 2017 to 2019. Males had double the AAMRs compared to females (overall AAMR: 15.7 vs. 8.0), yet both sexes experienced a final incline in death rates. Among the distinct racial and ethnic groups, non-Hispanic (NH) Whites (11.9) and NH Black/African Americans (10.9) portrayed the highest AAMRs. Patients most commonly died in medical facilities (41.03 %). Geographical disparities were evident with higher AAMRs in non-metropolitan areas (14.3) and the Midwest (12.7). States with the highest fatality involved West Virginia, Oklahoma, Kentucky, Mississippi, and Arkansas.

Conclusion: The abrupt rise in overall mortality rates for HF and LC from 2017 to 2019 is noteworthy. A focused analysis of demographic and geographic disparities is warranted to address this emerging trend.