Rising Mortality and Post-COVID shifts due to Stroke in Adults with Dyslipidemia in the U.S. from 1999 to 2023: Analysis of the CDC WONDER Database

Stroke is a leading cause of mortality and long-term disability in the U.S. and worldwide. Among its key modifiable risk factors, dyslipidemia plays a significant role by accelerating atherosclerosis and impairing cerebrovascular health, thereby substantially increasing stroke incidence. We analyzed stroke (ICD-10 codes: I60-I69)-related mortality in patients with dyslipidemia (ICD-10 code: E78), using the CDC-WONDER database from 1999 to 2023. Age-Adjusted Mortality Rates (AAMR) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC). A total of 94,118 stroke-related deaths in individuals with dyslipidemia were recorded aged ≥25 years. The AAMR observed a significantly steep incline from 0.5 in 1999 to 2.97 in 2023 (AAPC: 7.47; 95% CI: 6.54 to 8.40, p < 0.01). Men observed higher overall AAMR (1.64) than women (1.54). Among different races and ethnicities, Non-Hispanic Black population had the highest overall AAMR (1.79). Regionally, the highest overall AAMR was recorded by the West (1.98). Non-metropolitan areas had lower AAMR than metropolitan areas (1.7 vs 1.45). Stroke-related mortality among individuals with dyslipidemia has risen markedly in the U.S., despite the overall national decline in stroke mortality. This likely reflects the increasing prevalence of metabolic risk factors, an aging population, genetic predisposition, and inadequate lipid management in high-risk groups.