Rising Female Mortality in Combined Ischemic Heart Disease and Chronic Kidney Disease in the United States (1999–2023)

Background Although age-adjusted mortality from ischemic heart disease (IHD) has declined in the United States over recent decades, the coexistence of chronic kidney disease (CKD) may be reshaping mortality patterns. Emerging data suggest that improvements in cardiovascular survival may not be uniform across sexes. Methods We conducted a retrospective population-based study using CDC WONDER multiple cause-of-death data from 1999–2023. Deaths mentioning IHD (ICD-10 codes I20–I25) and CKD (ICD-10 code N18) were identified. Age-adjusted mortality rates (AAMRs) per 1,000,000 population were calculated using the 2000 U.S. standard population. Temporal trends were evaluated using Joinpoint Regression Program version 5.0 (National Cancer Institute) to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results Between 1999 and 2023, 633,221 deaths involved both IHD and CKD. Overall AAMR declined modestly (AAPC − 1.13%; 95% CI − 2.46 to 0.21; p = 0.093). Male mortality declined significantly (APC − 1.12%; 95% CI − 2.19 to − 0.03; p = 0.044). In contrast, female mortality increased significantly from 2015 to 2023 (APC 3.25%; 95% CI 0.78 to 5.79; p = 0.013). Similar increases were observed among middle-aged adults. Persistent regional and racial disparities were noted. Conclusions Despite modest national declines in cardiorenal mortality, a sustained rise in female mortality since 2015 signals a concerning reversal of cardiovascular progress. Targeted sex-specific prevention strategies are urgently needed.