After years of progress, mortality from heart attacks among older adults with kidney failure is climbing again—and hitting minority communities hardest. A new national analysis found that while deaths declined from 1999 to 2015, they have risen since, with non-Hispanic Black Americans facing the highest rates.
Between 1999 and 2023, more than 288,000 Americans aged 65 and older died from acute myocardial infarction (AMI) with renal failure. Non-Hispanic Black adults had an age-adjusted mortality rate of 35.8 per 100,000, compared to 26.4 for non-Hispanic Whites. Asian/Pacific Islander adults saw an 85% annual increase in mortality after 2020—the steepest rebound of any group.
Men consistently had higher mortality than women, and rural counties exceeded urban ones. The South and Midwest recorded the highest regional rates, with state-level disparities ranging threefold—from 14.5 in Utah to 43.0 in Rhode Island.
Despite these findings, the report does not break out treatment rates or access to care by race or ethnicity. Without this data, it’s impossible to know whether those most at risk are receiving timely interventions or preventive therapies. The authors stress the need for “cardiovascular-kidney-metabolic–focused prevention” and equitable access to acute cardiac care.
As mortality trends reverse, especially among vulnerable populations, the lack of detailed race-specific treatment data limits efforts to close gaps and save lives.
See: “Stalled progress and emerging disparities in acute myocardial infarction mortality among U.S. older adults (> 65 Years) with renal failure, 1999–2023” (July 31, 2025)
