Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023)

Background Cardiovascular diseases (CVD) remain a leading cause of mortality worldwide, while sudden deaths, encompassing both cardiac and non-cardiac causes, pose substantial public health challenges, particularly in settings with limited surveillance. In Oman, national data on long-term trends in cardiovascular and sudden-death mortality are scarce. Methods We conducted a retrospective, population-based time-trend analysis of national mortality data in Oman from 2014 to 2023 using the Ministry of Health Annual Health Statistical Reports. Cardiovascular deaths were defined according to ICD-10 circulatory system codes, while sudden deaths were defined as unexpected deaths occurring within 24 hours of symptom onset or last being seen alive. Age-standardized mortality rates (ASMRs) were calculated using the WHO world standard population. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC), complemented by Poisson regression models adjusting for population size. Results Over the 10-year period, age-standardized cardiovascular mortality declined substantially, decreasing from 38.49 per 100,000 population in 2014 to 25.71 per 100,000 in 2023 (AAPC − 4.38%, 95% CI − 5.65 to − 3.10). Declines were more pronounced among males (AAPC − 4.87%) than females (AAPC − 2.23%). Notably, females exhibited consistently higher age-standardized cardiovascular mortality than males across much of the study period, with a significant increase observed after 2020. In contrast, sudden death mortality remained high and temporally variable, with ASMRs peaking in 2021 (115.60 per 100,000) before declining in subsequent years. Joinpoint analysis demonstrated a significant increase in sudden death mortality between 2017 and 2021, followed by a significant decline after 2021. In contrast, Poisson regression indicated an overall increasing trend across the entire study period. Conclusions Between 2014 and 2023, Oman achieved meaningful reductions in age-standardized cardiovascular mortality, reflecting progress in cardiovascular prevention and care. However, the persistently high and fluctuating burden of sudden deaths, alongside emerging sex-specific disparities, particularly higher and rising cardiovascular mortality among females, highlights critical gaps in surveillance, prevention, and emergency response. Strengthening national sudden death monitoring, enhancing gender-responsive cardiovascular care, and expanding community-based emergency medical services are essential to further reduce premature mortality and support Oman Vision 2040 health goals.