Trends and Disparities in Stroke Mortality Among Adults with Hyperlipidemia in the United States, 1999–2023

Abstract Background Stroke is a leading cause of death in the U.S., with mortality trends influenced by hyperlipidemia, a significant risk factor for atherosclerosis and cardiovascular disease that can lead to ischemic stroke. This analysis examines stroke-related mortality in hyperlipidemia among adults aged 25 and older from 1999 to 2023. Methods A retrospective analysis of CDC WONDER investigated trends in mortality from Stroke (ICD codes: I60-I69) among Hyperlipidemia patients (ICD codes: E78.0, E78.1, E78.3, E78.4, E78.5) aged 25 and older. Joinpoint regression analysis calculated age-adjusted mortality rates (AAMR) per 100,000 individuals, annual percentage changes (APC), Average Annual Percent Change (AAPC), and 95% confidence intervals. Results Between 1999 and 2023, stroke and hyperlipidemia caused 241,308 deaths, with AAMRs of 1.38 in 1999 and 7.46 in 2023, an AAPC of + 7.16 (95% CI: 6.66 to 8.52). Adult men had higher AAMRs than women, with increases for both sexes [AAPC: + 7.20 vs. + 7.10; p < 0.001]. Black individuals had the highest AAMRs, followed by Hispanics. AAMR rose for all races, notably for Blacks/African Americans (AAPC: + 8.63%) and adults aged 65 and above (AAPC: + 7.35%). Northeast regions have the highest AAMRs, with the Midwest showing the most significant rise (AAPC: + 7.86%). AAMRs varied by state, from 2.0 in Georgia to 9.43 in Vermont in 2023. Non-metropolitan areas had higher AAMRs (4.31) than metropolitan areas (3.54). Conclusion This analysis reveals significant demographic and racial disparities in Stroke mortality among U.S. adults with Hyperlipidemia, which highlights the urgent need for targeted, equity-focused interventions to address these disparities.