Deterioration of Cardiovascular Mortality in the United States during the Period 2000-2018
Enrique Acosta1, Marcus Ebeling1, Neil Mehta2, Mikko Myrskyla1
1Max Planck Institute for Demographic Research, 2University of Texas Medical Branch at Galveston

The mechanisms at play for the recent stall in U.S. life expectancy improvements are not yet understood. Most analyses point to the deaths of despair as the main drivers of this stagnation. However, improvements in cardiovascular-related mortality are also decelerating and receive much less attention in research.
In this analysis, we aim to identify the cardiovascular causes that deteriorate the most, quantify their contribution to the life expectancy stall, and examine their temporal dynamics.
We found that three cardiovascular causes have contributed between 5% and 15% to the recent decreases in U.S. life expectancy. Our findings suggest a sharp increase in mortality from these three causes during the 2010s and a mortality disadvantage for cohorts 1985-1990. A similar pattern with drug-related mortality suggests a connexion between opioid abuse and an increased risk of cardiovascular mortality. This possibility implies a considerable underestimation of the opioid epidemic burden.