Temporal trends and disparities in mesenteric ischemia–associated cardiovascular mortality among U.S. adults aged ≥45 years, 1999–2023

Background Mesenteric ischemia (MI) is a highly fatal vascular condition associated with cardiovascular disease, but long-term national mortality patterns remain poorly described. Objective To evaluate national mortality trends, demographic heterogeneity, and geographic variations in MI and cardiovascular mortality among U.S. adults aged ≥45 years from 1999 to 2023. Methods We conducted a population-based analysis using CDC WONDER Multiple Cause of Death data. AAMRs per 100,000 population were computed, and temporal trends were evaluated using Joinpoint regression to estimate annual percent changes (APC) and average annual percent change (AAPC) with 95% confidence intervals. The analyses were stratified by sex, race/ethnicity, age group, urbanization, and census region. Results From 1999 to 2023, 61,543 deaths involving MI and cardiovascular diseases were recorded. The overall AAMR declined from 4.68 in 1999 to 1.47 in 2023, with an AAPC of −4.73% (95% CI: −5.16 to −4.30). Mortality decreased significantly until 2015 (APC: −6.86), followed by an increase thereafter (APC: +1.25). Women consistently had higher mortality than men and experienced a significant post-2016 increase, whereas men's rates plateaued. Non-Hispanic (NH) Black adults had the highest early rates (5.21 in 1999) and experienced a significant rise after 2016 (APC: 2.87%). Adults aged 45–64 years experienced the sharpest reversal, with mortality rising after 2013. Regionally, the South showed the greatest late increase, and urban–rural disparities persisted. Most deaths occurred in inpatient medical facilities (85.65%). Conclusion After nearly two decades of decline, MI-associated cardiovascular mortality has rebounded in the U.S. since 2015, underscoring the need for renewed prevention and equity-focused care.