. 2019 Aug 27;322(8):780–782. doi: 10.1001/jama.2019.9161

Table. Age-Adjusted Mortality Rates Attributable to Leading Cardiometabolic Underlying Causes of Death in the United States, 1999-2017.

	1999	2003	2007	2011	2013	2015	2017
Heart Disease
Overall AAMR^a	266.5	236.3	196.1	173.7	169.8	168.5	165.0
Subgroups
Black men^b	407.2	372.1	312.4	266.1	262.8	258.6	257.5
White men^b	327.1	288.2	240.3	216.9	213.1	211.2	208.3
AAMR ratio^c	1.24	1.29	1.30	1.23	1.23	1.22	1.24
Black women^b	283.7	258.5	209.8	176.2	172.1	165.7	161.9
White women^b	212.8	188.5	155.4	136.5	132	132.4	128.4
AAMR ratio^c	1.33	1.37	1.35	1.29	1.30	1.25	1.26
Trend period^d	1999-2010			2010-2017
Rate of change, β (95% CI)^e	−8.3 (−8.8 to −7.8) [P<.001]			−1.8 (−2.5 to −1.0) [P=.001]
Stroke
Overall AAMR^a	61.6	54.6	43.5	37.9	36.2	37.6	37.6
Subgroups
Black men^b	89.6	81.6	68.7	55.3	54.1	55.5	56.1
White men^b	60.8	52.9	41.3	36.2	35.0	36.1	36.2
AAMR ratio^c	1.47	1.54	1.66	1.53	1.55	1.54	1.55
Black women^b	76.2	71.1	56.4	47.0	44.7	46.7	47.0
White women^b	58.0	51.3	41.2	36.2	34.2	35.9	35.7
AAMR ratio^c	1.31	1.39	1.37	1.30	1.31	1.30	1.32
Trend period^d	1999-2010			2010-2017
Rate of change, β (95% CI)^e	−2.3 (−2.5 to −2.1) [P<.001]			−0.1 (−0.5 to 0.2) [P=.38]
Diabetes
Overall AAMR^a	25.0^f	25.5	22.8	21.6	21.2	21.3	21.5^f
Subgroups
Black men^b	49.4	51.2	46.1	44.9	44.0	43.9	45.2
White men^b	25.8	27.2	24.8	24.3	23.9	24.5	24.9
AAMR ratio^c	1.91	1.88	1.86	1.85	1.84	1.79	1.82
Black women^b	49.5	47.9	40.6	35.8	34.3	31.9	31.8
White women^b	20.2	20.1	17.5	16.2	15.7	15.6	15.2
AAMR ratio^c	2.45	2.38	2.32	2.21	2.18	2.04	2.09
Trend period^d	1999-2010			2010-2017
Rate of change, β (95% CI)^e	−0.4 (−0.6 to −0.3) [P<.001]			0.02 (−0.1 to 0.1) [P=.64]
Hypertension
Overall AAMR^a	6.2	7.6	7.6	8.1	8.5	8.5	9.0
Subgroups
Black men^b	17.3	19.1	17.8	17.4	18.3	17.9	18.5
White men^b	5.2	6.2	6.5	7.2	7.7	7.9	8.5
AAMR ratio^c	3.33	3.08	2.74	2.42	2.38	2.27	2.18
Black women^b	15.0	16.9	15.7	14.9	14.7	14.8	15.0
White women^b	5.2	6.6	6.6	7.1	7.4	7.3	7.6
AAMR ratio^c	2.88	2.56	2.38	2.10	1.99	2.03	1.97
Trend period^d	1999-2003		2003-2017
Rate of change, β (95% CI)^e	0.3 (0.3 to 0.4) [P=.001]		0.1 (0.04 to 0.1) [P=.001]

Abbreviation: AAMR, age-adjusted mortality rate.

^{^a}

The AAMR indicates rate per 100 000 population, directly standardized to the 2000 US Census population.

^{^b}

Race information of the decedent was reported as standard practice by the funeral director, as provided by an informant (often the surviving next of kin), or in the absence of an informant, on the basis of observation.²

^{^c}

AAMR ratio indicates a comparison of AAMRs by race within a sex group (eg, black men compared with white men).

^{^d}

Calculated using linear regression of overall population AAMR before and after inflection point, identified by Joinpoint analysis of heart disease, stroke, diabetes, or hypertension trend. P < .05 for comparison of linear trend of AAMR after vs before inflection point for all diseases.

^{^e}

P value for statistical significance of first and second linear regression around Joinpoint regression identified inflection point in overall AAMR trend. β coefficient represents change in AAMR per year.

^{^f}

The crude mortality rate was 24.5 per 100 000 in 1999 and 25.7 per 100 000 in 2017, but calculation of the weighted average based on the 2000 US Census population resulted in AAMRs of 25.0 per 100 000 in 1999 and 21.5 per 100 000 in 2017.