# Temporal Trends in Mortality Related to Hyperthyroidism and Heart Failure in the United States

## TL;DR

This study examines how deaths from hyperthyroidism with heart failure have changed over time in the US, finding rising disparities among certain groups.

## Contribution

The study provides new insights into the evolving mortality trends and disparities associated with hyperthyroidism and heart failure in the US population.

## Key findings

- Mortality rates initially increased from 1999 to 2001, declined until 2011, then increased again from 2011 to 2020.
- Females, White individuals, and those in metropolitan areas had the highest mortality rates.
- Disparities increased over time, with notable rises in mortality rates among females and White individuals after 2013.

## Abstract

Introduction: Hyperthyroidism is one of the most frequently diagnosed disorders in the United States (US), and its association with heart failure (HF) remains underexplored. Understanding this relationship is critical for identifying high-risk populations and guiding preventive efforts.

Aims: This study aimed to analyze temporal and demographic trends in mortality where hyperthyroidism was the underlying cause and HF a contributing cause, using national data from 1999 to 2020.

Methodology: A retrospective observational study was conducted using the Centers for Disease Control and Prevention (CDC) Multiple Causes of Death (MCD) database to assess mortality trends in individuals aged ≥25 years in the US from 1999 to 2020. The study included deaths in which hyperthyroidism (ICD-E05) was listed as an underlying cause and HF (ICD-i50) as a contributing cause. Data were analyzed by gender, race, geographic area, and place of death. Age-adjusted mortality rates (AAMRs) and annual percentage changes (APCs) were calculated.

Results: A total of 1,189 deaths were documented. The AAMR initially increased (25.95% APC from 1999 to 2001), followed by a decline from 2001 to 2011 (-5.04% APC); however, it increased from 2011 to 2020 (1.83% APC). The highest mortality was observed in females (70%), White individuals (73.93%), and those living in metropolitan regions (75.4%). Temporal trends showed an increasing AAMR in females (APC: +3.74% after 2013) and White individuals (APC: 8.16% from 2017 to 2020), indicating evolving disparities.

Conclusions: Mortality trends in hyperthyroidism with HF have shifted, with increasing disparities in gender and race. These findings emphasize the need for targeted prevention strategies and improved healthcare access.