MON-283 - The Rising Burden of Obesity-Related Cardiovascular Mortality Among Women in the United States: 1999-2020

Background: Obesity is a significant risk factor for cardiovascular disease (CVD), yet population-level trends in obesity-related CVD mortality among U.S. women remain poorly characterized. This study aimed to examine trends and disparities in obesity-related CVD mortality among U.S. women from 1999 to 2020.

Methods: We analyzed mortality data from the National Center for Health Statistics for U.S. women aged 35 years and older. Deaths attributed to obesity-related CVD were identified using International Classification of Diseases (ICD) codes. We calculated crude mortality rates per 100,000 population and estimated annual percentage changes (EAPC) with 95% confidence intervals (CI) using joinpoint regression analysis. Stratified analyses examined trends by age, race/ethnicity, geographic region, urbanization status, and state.

Results: From 1999–2020, obesity-related CVD mortality accounted for 122,697 deaths among U.S. women, with annual deaths increasing from 3,042 (1999) to 10,575 (2020). Crude mortality rose from 2.1 to 6.3 per 100,000, representing a steady increase (EAPC 4.76% per year, 95% CI 4.45–5.07; p< 0.001). Regional analysis showed the South had the highest cumulative deaths (46,313), while the Midwest experienced the fastest increase (EAPC 5.57%). Nonmetropolitan areas demonstrated higher mortality rates (4.4 per 100,000 in both Micropolitan and Noncore areas) and steeper trends compared to large metropolitan areas (2.7 per 100,000). Burden concentrated in ages 55–64 (31,259 deaths) and 45–54 (24,231 deaths), though rates increased across all adult age groups, including younger women aged 35–44 (EAPC 4.82%; 1.4-4.2 per 100,000). Black women experienced higher baseline mortality (6.3 per 100,000; 30,243 deaths) than White women (3.3 per 100,000; 90,215 deaths), though White women showed steeper increases (EAPC 5.02% vs. 4.05%). Crude mortality increased for both Hispanic (0.7-2.7 per 100,000; EAPC 5.46%) and non-Hispanic women (2.3-7.1 per 100,000; EAPC 4.97%). State-level analysis revealed substantial heterogeneity, with Oklahoma showing the highest 2020 mortality rate (15.9 per 100,000) and steepest trend (EAPC 9.85%), followed by Wisconsin (11.0 per 100,000; EAPC 8.73%) and Iowa (9.5 per 100,000; EAPC 8.23%).

Conclusions: Obesity-related CVD mortality among U.S. women increased substantially from 1999 to 2020, with disparities evident across age, race/ethnicity, geography, and urbanization. The rising burden in younger age groups and rural areas warrants urgent public health attention and targeted interventions to reduce obesity prevalence and improve cardiovascular health outcomes.

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