Cardiovascular deaths among adults with obesity have tripled over the past 25 years, but Black Americans face a disproportionate toll that far exceeds other racial and ethnic groups, according to a comprehensive analysis of more than 363,000 deaths.
Non-Hispanic Black adults consistently showed the highest age-adjusted mortality rates throughout the study period, reaching 18.30 deaths per 100,000 population in 2023. This represents nearly double the rate for non-Hispanic white adults at 10.38 per 100,000 and nearly triple the rate for Hispanic adults at 6.28 per 100,000.
Overall, cardiovascular mortality among adults with obesity surged from 3.40 to 10.34 per 100,000 between 1999 and 2023, with dramatic acceleration during the pandemic years from 2018 to 2021. Men experienced higher mortality than women across all groups, with rates of 12.69 versus 8.06 per 100,000 in 2023.
The study revealed profound geographic disparities as well. The South transformed from having the lowest regional burden in 1999 to the highest by 2023, a shift researchers attribute to structural barriers and social determinants of health.
The disease spectrum also evolved dramatically, with hypertensive heart diseases showing an 804 percent increase. Atherosclerotic conditions collectively represented over half of leading causes by 2023.
Researchers emphasized that these widening disparities demand urgent recognition of obesity as requiring comprehensive cardiovascular management, particularly aggressive blood pressure control. They called for health care interventions specifically targeting highest-risk populations, including Black adults, older adults, and Southern residents.
See: “Temporal Trends and Disparities in Cardiovascular Mortality Among Adults With Obesity in the United States From 1999 to 2023” (February 11, 2026)
