Dual Burden of Atrial Fibrillation and Substance Abuse in Older Adults: Nationwide Mortality Trends in the United States, 1999-2023

Dual Burden of Atrial Fibrillation and Substance Abuse in Older Adults: Nationwide Mortality Trends in the United States, 1999-2023 | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 29 August 2025 V1 Latest version Share on Dual Burden of Atrial Fibrillation and Substance Abuse in Older Adults: Nationwide Mortality Trends in the United States, 1999-2023 Authors : Shahreena Athar Siddiqui 0009-0009-8542-0488 , Nafila Zeeshan , Muhammad Hanzalah Atif 0009-0009-0653-6176 , Areeba Aamir Ali Basaria , Hamayel Qadir , Livana Sarupani 0009-0001-8727-0438 , Laiba Sultan 0009-0009-7485-7289 , Jazza Aamir , and Raheel Ahmed [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.175648076.66082526/v1 189 views 126 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract ABSTRACT Background: Atrial fibrillation and substance abuse are increasingly prevalent conditions, contributing substantially to global morbidity and mortality. Both are strongly associated with cardiovascular diseases, as well as other serious health complications. However, trends in mortality related to atrial fibrillation and substance abuse remain underexplored. Methods: A retrospective analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023) identified deaths via ICD-10 codes. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Joinpoint regression assessed annual percentage changes (APC) and average annual percentage changes (AAPC). Data were stratified by year, sex, race/ethnicity, region, state, urbanization and Place of death. Results: From 1999-2023, 304,085 deaths were recorded. AAMR rose from 2.06 in 1999 to 48.3 in 2023, with a significant overall AAPC of 15.3 (95% CI: 13.1 to 17.7). Men had higher AAMRs than women (38.5 vs 17.3), with rising trends in both: men (AAPC: 14.7; (95% CI: 12.3 to 17.2)), women (AAPC: 15.4; 95% CI: 13.3 to 17.5). Regionally, the Midwest had the highest AAMR (33.9), followed by the Northeast (AAMR: 24.3), the South (AAMR: 23.9) and the West (AAMR: 22.8), with the Midwest showing the most significant change overall (AAPC: 15.9; 95% CI: 13.6 to 18.2). AAMR rose across all races, with the highest in NH White (30.3), followed by Black or African American (12.8). Non-metropolitan areas had higher AAMRs than metropolitan (30.8 vs 21.0), with a greater overall change (AAPC: 18.8; 95% CI: 15.8 to 21.9). Mortality rates across states ranged from 76.9 (Vermont) to 6.47 (Mississippi). Overall, adults aged 85 and older exhibited a higher crude mortality rate (CMR: 61.9) as compared to 75-84 years (CMR: 34.1) and 65-74 (CMR: 12.0) years age groups. Conclusion: From 1999 to 2023, mortality rates rose across all groups, with the greatest burden in NH White, men, adults aged 85 years and older, and the Midwestern rural areas. Targeted interventions are needed to mitigate these significant disparities. Supplementary Material File (atrial fibrillation and substance abuse in older adults final.docx) Download 42.19 KB File (figure.docx) Download 568.62 KB File (supplementary.docx.pdf) Download 394.63 KB Information & Authors Information Version history V1 Version 1 29 August 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords basic: atrial fibrillation/atrial arrhythmias clinical: catheter ablation – atrial fibrillation clinical: catheter ablation – atrial flutter clinical: electrophysiology – atrial arrhythmias clinical: implantable devices – atrial fibrillation Authors Affiliations Shahreena Athar Siddiqui 0009-0009-8542-0488 Dow Medical College View all articles by this author Nafila Zeeshan Dow Medical College View all articles by this author Muhammad Hanzalah Atif 0009-0009-0653-6176 Dow Medical College View all articles by this author Areeba Aamir Ali Basaria Dow Medical College View all articles by this author Hamayel Qadir Dow Medical College View all articles by this author Livana Sarupani 0009-0001-8727-0438 Dow Medical College View all articles by this author Laiba Sultan 0009-0009-7485-7289 Dow Medical College View all articles by this author Jazza Aamir Dow Medical College View all articles by this author Raheel Ahmed [email protected] Newcastle Upon Tyne Hospitals NHS Foundation Trust View all articles by this author Metrics & Citations Metrics Article Usage 189 views 126 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Shahreena Athar Siddiqui, Nafila Zeeshan, Muhammad Hanzalah Atif, et al. Dual Burden of Atrial Fibrillation and Substance Abuse in Older Adults: Nationwide Mortality Trends in the United States, 1999-2023. Authorea . 29 August 2025. DOI: https://doi.org/10.22541/au.175648076.66082526/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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