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Obesity-linked deaths in US triple since 1999

Obesity in the US is ballooning, with the number of adults who died of heart disease and whose death records cited obesity as a contributing factor being three times greater in 2020 than in 1999, according to research.

The findings, published in the Journal of the American Heart Association, comes from analysis of death certificates in a database maintained by the US Centres for Disease Control and Prevention (CDC), reports The Washington Post.

There were 281 135 deaths from heart disease linked to obesity in that time range, the researchers said, and the death rate tripled from 2.2 deaths per 100 000 people to 6.6 deaths per 100 000.

The increase in obesity-related deaths contrasted with a steady decline (nearly 18%) in heart disease deaths overall from 1999 to 2020.

The mortality rate from heart disease tied to obesity was higher among the black population than among any other racial group. Overall, the deaths also were more common among men than women, although black women had a slightly higher mortality rate than black men.

Obesity, a major risk factor for heart disease, affects about 115m people in the US – about 42% of adults and 20% of children.

The study noted that the adult percentage has risen by nearly 10% in the past decade.

The researchers found that ischaemic heart disease (narrowed arteries) and high blood pressure were the most common causes of obesity-related heart disease deaths in the two decades they tracked.

Study details

Racial disparities in obesity‐related cardiovascular mortality in the US: Temporal Trends from 1999 to 2020

Zahra Raisi‐Estabragh, Ofer Kobo, Jennifer Mieres, Renee Bullock‐Palmer, Harriette Van Spall, Khadijah Breathett, Mamas Mamas.

Published in Journal of the American Heart Association on 19 Septemver 2023


Obesity is a major risk factor for cardiovascular disease, with differential impact across populations. This descriptive epidemiologic study outlines trends and disparities in obesity‐related cardiovascular mortality in the US population between 1999 and 2020.

Methods and results
The Multiple Cause of Death database was used to identify adults with primary cardiovascular death and obesity recorded as a contributing cause of death. Cardiovascular deaths were grouped into ischaemic heart disease, heart failure, hypertensive disease, cerebrovascular disease, and other. Absolute, crude, and age‐adjusted mortality rates (AAMRs) were calculated by racial group, considering temporal trends and variation by sex, age, and residence (urban versus rural). Analysis of 281 135 obesity‐related cardiovascular deaths demonstrated a 3‐fold increase in AAMRs from 1999 to 2020 (2.2‐6.6 per 100 000 population). Black individuals had the highest AAMRs. American Indian or Alaska Native individuals had the greatest temporal increase in AAMRs (+415%). Ischaemic heart disease was the most common primary cause of death. The second most common cause of death was hypertensive disease, which was most common in the black racial group (31%). Among black individuals, women had higher AAMRs than men; across all other racial groups, men had a greater proportion of obesity‐related cardiovascular mortality cases and higher AAMRs. Black individuals had greater AAMRs in urban compared with rural settings; the reverse was observed for all other races.

Obesity‐related cardiovascular mortality is increasing with differential trends by race, sex, and place of residence.


AHA Journal article – Racial disparities in obesity‐related cardiovascular mortality in the US: Temporal Trends from 1999 to 2020 (Open access)


The Washington Post article – Obesity as a factor in cardiac deaths tripled over 20 years (Restricted access)


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New US guidelines recommend weight loss drugs for obesity


Obesity contributes to up to half of new diabetes cases annually in the US


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