Cardiovascular Disease Mortality in Patients with Hypothyroidism: A 22-Year National Analysis of US Trends and Disparities
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Hypothyroidism is a prevalent endocrine disorder that has been linked to adverse cardiovascular outcomes. However, national-level trends and disparities in cardiovascular disease (CVD)-related mortality among individuals with hypothyroidism remain incompletely characterized. This study aimed to evaluate long-term temporal trends and demographic disparities in CVD mortality among US adults with hypothyroidism. Methods: We conducted a retrospective population-based analysis using death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2020. Adults aged ≥25 years with hypothyroidism were identified using ICD-10 codes E02–E03, with CVD-related deaths defined by ICD-10 codes I00–I99. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 US standard population. Temporal trends were analyzed using joinpoint regression to estimate annual percent change (APC), and subgroup analyses were performed by sex, race/ethnicity, age group, urban-rural status, and place of death. Results: Between 1999 and 2020, 382,906 CVD-related deaths were associated with hypothyroidism, corresponding to an overall AAMR of 8.00 per 100,000. Mortality rates increased steadily over the study period, peaking at 10.12 per 100,000 in 2020, with the most pronounced rise occurring between 2018 and 2020 (APC 14.01%). Women accounted for nearly three times as many deaths as men, although mortality rates increased more rapidly among men. Non-Hispanic white individuals exhibited the highest absolute mortality burden, while Hispanic populations experienced the fastest growth in mortality rates. The largest relative increases were observed among adults aged 35–44 and 45–54 years. Mortality rates were consistently higher in rural compared with urban areas, and the majority of deaths occurred in long-term care facilities. Conclusion: CVD-related mortality among US adults with hypothyroidism has risen substantially over the past two decades, with marked disparities across sex, age, race/ethnicity, and geographic location. These findings highlight the need for targeted cardiovascular risk assessment, early detection of hypothyroidism, and integrated management strategies, particularly in high-risk and underserved populations, to mitigate rising mortality and reduce health inequities.
Source: Endocrinology Insights
DOI: 10.1159/000551147
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7141482528
FWCI:
Cites:
Cited by:
Related to: