Trends in Sudden Cardiac Death Related Mortality in Adults in the United States: A CDC WONDER Database Analysis, 1999–2020

ABSTRACT Background Sudden cardiac death (SCD) is a leading cause of mortality in the United States, with significant variations across demographic and geographic factors. This study analyzes trends in SCD‐related mortality among adults (> 25 years) from 1999 to 2020 using the CDC WONDER database. Methods We extracted data on SCD‐related deaths (ICD‐10 code I46.1) and calculated age‐adjusted mortality rates (AAMR) per 100 000 population, stratified by sex, race/ethnicity, urbanization, and census region. Joinpoint regression was performed to estimate the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CI). Results A total of 279 599 SCD‐related deaths were recorded from 1999 to 2020. Overall AAMR declined significantly (AAPC: −1.20%; 95% CI: −1.58% to −0.82%) until 2018, followed by a sharp increase from 2018 to 2020 (APC: +6.93%; 95% CI: +3.04% to +10.96%). Declines were most pronounced in American Indian/Alaska Native populations (−3.67%), while the highest increases post‐2018 were observed in Hispanic (+13.1%) and Asian/Pacific Islander groups (+12.3%). Urban areas experienced greater post‐2018 increases compared to rural areas. Regional disparities were evident, with the West showing the steepest rise in mortality. Conclusion While SCD mortality declined from 1999 to 2018, a concerning reversal has emerged since 2018, particularly in specific racial/ethnic groups and urban areas. Further research is needed to investigate underlying causes, including the potential impact of COVID‐19, healthcare disparities, and lifestyle factors.