Persistent Excess Cardiovascular Mortality in Black Adults
Key Takeaways
- Black adults in the United States continued to have higher cardiovascular mortality than white adults in 2024.
- Excess age-adjusted cardiovascular mortality fell 2.7% from 2023 to 2024, with a larger decline in men than in women.
- The remaining 2024 burden was 110.4 excess cardiovascular deaths per 100,000 population and more than 1 million excess years of potential life lost.
- Hypertension led the condition-specific burden, followed by ischemic heart disease and cerebrovascular disease, while heart failure moved in the opposite direction for Black women as other categories declined.
Adith S. Arun and colleagues produced the third annual American College of Cardiology update on excess cardiovascular death among Black Americans, covering trends from 2000 to 2024. Investigators used the CDC’s Wide-ranging Online Data for Epidemiologic Research (WONDER) to compare Black adults with white adults on age-adjusted mortality and years of potential life lost across overall cardiovascular disease (CVD), ischemic heart disease, hypertension, cerebrovascular disease, and heart failure (HF).
Excess age-adjusted CVD mortality among Black adults relative to white adults declined 2.7% from 2023 to 2024, with a larger year-over-year improvement in men than women at 4.3% and 0.7%, respectively. The sex-combined excess age-adjusted overall CVD mortality rate nevertheless remained 110.4 per 100,000 population in 2024. The researchers described that pattern as continued recovery from the 2020 peak rather than elimination of the disparity.
That remaining burden translated to more than 1 million excess years of potential life lost, with about 58% occurring among Black men. Hypertension had the strongest association with excess age-adjusted mortality, followed by ischemic heart disease and cerebrovascular disease. Across condition-specific categories, excess mortality declined among Black men for ischemic heart disease, hypertension, cerebrovascular disease, and HF, whereas Black women also saw declines in the non-HF categories but had a 5.7% increase in HF excess mortality.
The authors said the 2024 update suggested partial recovery from pandemic-era widening but not a return to the earlier trajectory of modest decline. They also wrote that advances in cardiovascular science and care had not yet translated into convergence in cardiovascular survival between Black and white Americans.
Clinician Questions
What outcomes were used to track excess cardiovascular mortality among Black adults in this U.S. analysis?
Investigators used CDC WONDER data to compare Black adults with white adults on age-adjusted mortality and years of potential life lost due to overall CVD, ischemic heart disease, hypertension, cerebrovascular disease, and HF from 2000 to 2024.
Which cardiovascular conditions contributed most to excess mortality among Black adults, and did that pattern differ by sex?
Hypertension had the strongest association with excess age-adjusted mortality, followed by ischemic heart disease and cerebrovascular disease. The clearest sex-specific difference was in HF: excess mortality declined across the listed categories among Black men, whereas Black women had declines in the non-HF categories but an increase in HF excess mortality.
How did the authors interpret the 2024 trend in excess cardiovascular mortality among Black adults?
The authors framed the 2024 pattern as partial recovery from pandemic-era widening rather than a return to the earlier trajectory of modest decline, and they wrote that convergence in cardiovascular survival between Black and white Americans had not yet occurred.