Out of 117,933 seizure- and CVD-related deaths, IHD led, followed by arrhythmias and HF. Most deaths occurred in medical facilities (40.3%) and nursing homes (32.4%). The highest AAMR was seen among seizure patients with arrhythmias (6.1), followed by IHD (6.0) and HF (4.2). Seizure and CVD-related mortality initially declined from 1999 to 2008 (APC: -4.8; 95% CI: -5.8 to -3.7), remained stable for a period, and then increased from 2016 to 2023 (APC: 6.0; 95% CI: 4.6 to 7.3). By CVD subtype, mortality among seizure patients with IHD decreased (AAPC: -2.2; 95% CI: -3.1 to -1.3), while mortality increased in patients with seizures and arrhythmias (AAPC: 2.2; 95% CI: 1.0 to 3.4). The AAMRs for seizure and HF patients remained similar throughout (AAPC: -0.2; 95% CI: -1.2 to 0.8). Overall, males (12.1) had higher AAMRs than females (9.6). NH Black adults had the highest rate (20.0), followed by NH White (10.3) and Hispanics (8.0). Regional AAMRs were similar (10.2 to 11.2). State-wise, AAMR was highest in District of Columbia (19.4) and lowest in Arizona (5.6)

Seizure- and CVD-related mortality initially declined but rose again after 2016, with arrhythmia-related deaths increasing steadily. Disparities were noted among males and NH Blacks. These results highlight the need for improved management and targeted interventions.