Cardiac Arrest and Cardiomyopathy Related Mortality in the United States, 1999-2025: Trends and Disparities

Abstract

Background: Cardiac arrest and cardiomyopathy are major contributors to cardiovascular mortality and sudden death. However, long-term national mortality trends and demographic disparities remain unclear. This study aimed to evaluate U.S. mortality trends from 1999 to 2025 and assess differences by sex, race/ethnicity, and age. Methods: We conducted a cross-sectional analysis of U.S. mortality data from 1999–2025 using the CDC WONDER Multiple Cause-of-Death database. Deaths among adults aged ≥25 years were identified using ICD-10 codes I42 (cardiomyopathy) and I46 (cardiac arrest), including cases where these codes appeared as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Temporal trends were assessed using Joinpoint regression and expressed as average annual percent change (AAPC), stratified by sex, race/ethnicity, and three age groups (25–44, 45–64, and ≥65 years). Results: Between 1999 and 2025, 237,958 deaths from cardiac arrest and cardiomyopathy occurred among U.S. adults ≥25 years. Overall, AAMR declined from 6.33 to 2.41 (AAPC −3.83; 95% CI: −4.18 to −3.57). Males had higher mortality than females (AAMR 5.82 vs 2.71) with declines from 9.13 to 3.28 and 4.36 to 1.62, respectively. Non-Hispanic (NH) Black individuals had the highest AAMR (7.42), followed by Hispanics (4.62). Mortality was highest among those aged ≥65 years (CMR 14.74), declining from 23.88 to 7.88 between 1999 and 2025. Conclusion: Mortality from cardiac arrest and cardiomyopathy declined significantly from 1999–2025. However, substantial disparities persisted, with higher mortality among males, NH Black individuals, and adults ≥65 years, highlighting ongoing inequities in cardiovascular outcomes.