WASHINGTON – Ischemic heart disease (IHD) due to tobacco use is rapidly rising in the U.S., and there are corresponding regional and racial disparities in the burden of use, a new abstract shows. Roopeessh Vempati, MD, of Trinity Health Oakland Hospital, Pontiac, Michigan, presented these results in the form of an Abstract during a poster session on Friday at the Society for Cardiovascular Angiography & Interventions (SCAI) Scientific Sessions, 2025, in Washington, DC. Tobacco use is one of the most preventable causes of cardiovascular disease (CVD), but rates of tobacco-related CVD mortality remain high in the U.S. The investigators in this study examined the trends in tobacco use among residents of the U.S. between 1999 and 2020. They also projected potential and expected trends through 2030. The WONDER database from the Centers for Disease Control and Prevention (CDC) was used to assess age-adjusted mortality rates (AAMRs) in people who were older than 25 years who had IHD due to tobacco use. Disparities by sex, race and geography were investigated as well, and statistical modeling in R was used to predict future IHD mortality rates attributable to tobacco use. Annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence intervals (CI) and significance levels were computed for assessing changes in AAMRs over time. Tobacco-related IHD deaths were identified using ICD-10 codes. Tobacco-related IHD deaths rose significantly from 1999 (n=4,669) to 2020 (n=56,367). Projections for 2030 estimate that this death toll will rise to 80,985 deaths (43.7% increase from 2020). All age groups experienced an increase in AAMRs, but men had a particularly sharp rise between 1999 and 2005 (APC=40.39). Men showed a consistent rise in AAMRs from 2005 to 2020 as well (APC=2.34), for an overall AAPC of 11.93. White men had the highest increase overall (AAPC=12.01), followed by American Indian/Alaska Native (AI/AN) men (AAPC=10.46). More gradual increases were seen in women, and APCs slowed after 2005. Black women had the highest AAPC of the women at 10.39. Women who were AI/AN had borderline insignificant rises (AAPC=1.34, p=0.052), and Asian women had a mild increase followed by a steady decline. AI/AN and Asian or Pacific Islander individuals experienced steep increases early-on (APC>30), but these stabilized later, leading to overall AAPCs of 9.76 and 11.46. One of the sharpest surges was observed in Black Americans between 2001 and 2005 (APC=46.98), with a slow rise after and a final APC of 10.85. Overall, all subgroups for race and sex showed significant increases in AAMRS, with the exception of a few female subpopulations. At the state level, residents of Vermont (40.2) and North Dakota (38.3) had the highest AAMRs, while California (2.3) and Massachusetts (4.9) had the lowest, indicative of geographic disparities. The investigators concluded that there are clear disparities in race, sex and geography in tobacco-related IHD mortality in the U.S., and, despite efforts to control tobacco use, these mortality rates continue to rise. Source: Vempati R. A public health challenge: Trends, disparities, and projections in tobacco-related ischemia heart disease mortality (1999-2030). 2025 May 2. Image Credit: luciano – stock.adobe.com