National trends in mortality among decedents with co-occurring vascular disorders of the intestine and ischemic heart disease, United States, 1999–2023

Abstract Background Vascular disorders of the intestine (VDI) and ischemic heart disease (IHD) are linked by shared atherosclerotic risk factors including diabetes, hypertension, and smoking. Their coexistence poses a significant threat to population health, with associated high morbidity and mortality. While advances in care have improved outcomes, evolving trends and disparities remain under-investigated at the national level. Objective This study assessed national mortality trends and demographic disparities in deaths attributed to vascular disorders of the intestine and ischemic heart disease among all age groups in the United States from 1999 to 2023. Methods We used the CDC WONDER Multiple Cause of Death database (1999–2023) and identified deaths in which ICD-10 code K55 (vascular disorders of the intestine) and ICD-10 codes I20–I25 (ischemic heart disease) were concurrently listed on the same death certificate. Age-adjusted mortality rates were calculated and stratified by sex, race/ethnicity, and U.S. census regions. Joinpoint regression analysis was applied to evaluate temporal trends and compute annual percent change with 95% confidence intervals. Results A total of 69,897 deaths met the predefined co-occurrence criteria, with both K55 and I20–I25 listed on the same death certificate during the 24-year study period. National age-adjusted mortality rates showed a significant decline from 1999 to 2015, followed by a plateau through 2023. Males exhibited initially higher mortality than females, though both experienced overall reductions. Regional analysis revealed consistent early declines across all census regions, with later stagnation in the Midwest, South, and West. Ethnic disparities persisted, with Hispanic, Black, and White populations experiencing higher mortality rates compared with Asian or Pacific Islander individuals. Conclusion National mortality from vascular disorders of the intestine has declined over two decades, but recent stagnation and persistent disparities highlight the need for targeted prevention and equitable healthcare access.