Demographic and regional mortality trends in dilated cardiomyopathy in the United States; 1999-2020.

Background: Dilated cardiomyopathy significantly impacts mortality and hospitalizations in the U.S., yet trends in dilated cardiomyopathy-related mortality are underreported. This retrospective study examines the trends in dilated cardiomyopathy-related mortality between 1999 and 2020. Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was analyzed to study the trends in dilated cardiomyopathy-related mortality. Age-adjusted mortality rates per 100,000 people and annual percent changes with 95% CIs were determined. Joinpoint regression analysis was used to assess the trends in the overall demographic, geographic, and place-of-death variables. Results: There were 168,702 dilated cardiomyopathy-related deaths reported between 1999 and 2020. The age-adjusted mortality rate declined from 3.40 in 1999 to 1.71 in 2020. Men unfailingly had a higher age-adjusted mortality rate than women. Non-Hispanic Black or African Americans had the highest age-adjusted mortality rate compared to other races, with a recent increase in annual percent change from 2015 to 2020. Hispanics, or Latinos, also showed an alarming rise in annual percent change of 11.10 from 2018 to 2020. Significant geographical variations were noted, with states in the top 90th percentile (Michigan, Washington, and Delaware) having approximately three times the age-adjusted mortality rate compared to states that fell in the lower 10th percentile. Conclusion: Despite overall declines, racial and regional disparities persist, owing to the growing clinical burden. Targeted research and interventions are key to addressing disparities and reducing dilated cardiomyopathy-related mortality.