US heart disease deaths linked with substance use rose 4% per year between 1999-2019

Cardiovascular disease (CVD) deaths involving substance use (SU) rose an average of 4% per year from 1999 to 2019, despite a drop in overall cardiovascular disease deaths, according to research published in the Journal of the American Heart Association. Publicly available data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database were reviewed to investigate death trends related to substance use from 1999 and 2019.
636,572 substance use-related CVD deaths were identified. Of these, 75.6% were among men, and 70.6% of the individuals were non-Hispanic white people. Smoking/tobacco use was not included as a form of substance use in this study.
The analysis found that the overall rate of substance use-related CVD deaths increased from 9.9 per 100,000 population in 1999 to 21.4 per 100,000 population in 2019, representing an average annual increase of 4%. Increases in substance use-related average annual percent changes were noted across all subgroups and were pronounced among women (4.8%); American Indian or Alaskan individuals (5.4%); younger adults, ages 25-59 (5.3%); people living in rural areas (5%); people who used cannabis (12.7%) and psychostimulants (16.8%). 65% of cardiovascular disease deaths were related to alcohol, followed by opioids (13.7%), cocaine (9.8%), stimulants (6.5%), sedatives (4.1%) and cannabis (0.5%). The highest rate of change was noted among adults aged 25-39 (5.3%), followed by adults aged 55-69 (4.9%). The age-adjusted death rate was 15.2 per 100,000 in adults living in non-metropolitan/rural areas, 22.5 per 100,000 in men; and 37.7 per 100,000 in American Indian or Alaska Native adults.
The study found that there was a prominent increase in SU+CVD‐related mortality in the USA between 1999 and 2019. Women, non‐Hispanic American Indian or Alaska Native individuals, younger individuals, nonmetropolitan area residents, and users of cannabis and psychostimulants had pronounced increases in SU+CVD mortality. The increases in substance use found in rural areas have been connected to socioeconomic vulnerabilities, access to health care and substance abuse treatment differences and will require further evaluation, the researchers noted.
Source Abdul Mannan Khan Minhas, Jakrin Kewcharoen , Michael E. Hall , et al. Temporal Trends in Substance Use and Cardiovascular Disease–Related Mortality in the United States, Journal of the American Heart Association. 2024.