J Thromb Thrombolysis. 2026 May 24. doi: 10.1007/s11239-026-03281-9. Online ahead of print.
ABSTRACT
Pulmonary embolism (PE) is a preventable yet often deadly cardiovascular event. We aimed to investigate PE mortality trends from 1968-2023 and forecast rates through 2040 in the U.S. We analyzed CDC WONDER death certificates for adults ≥ 25 years. Age-adjusted mortality rates (AAMRs), annual percent changes (APCs) were used to analyse trends and Auto-ARIMA/Prophet forecasting models were used for future projections, all stratified by sex, age, race, and contributing cause of death. From 1968-2023, 516,187 PE deaths occurred, with a mean AAMR of 6.06 per 100,000 (AAPC -1.85). Mean AAMRs were 6.76 in men and 5.57 in women. By age, rates averaged 0.98 for adults 25-44 years, 3.96 for 45-64 years, and 21.73 for ≥ 65 years. Black adults had a mean AAMR of 10.87 versus 5.76 in White adults. From 1999-2023, PE death linked to Coronary Artery Disease, COPD, infection, and diabetes declined, while PE death linked to hypertension rose and heart failure related PE plateaued. Forecasts project an overall AAMR of 3.63 by 2040 (2.32 in men, 3.25 in women), with the highest predicted rate of 9.24 among adults ≥ 65 years. Projected racial AAMRs are 3.70 in White and 7.71 in Black individuals. Hypertension and heart failure linked rates are expected to rise further. Despite a sustained decline in PE death since 1968, persistent racial gaps, aging populations, and rising hypertension and heart-failure related PE threaten progress, highlighting the need for targeted prevention and equitable cardiovascular risk management.
PMID:42177745 | DOI:10.1007/s11239-026-03281-9