This study aims to examine the sociodemographic mortality trends and disparities related to cerebrovascular disease among the young population.

Cerebrovascular disease (CeVD) is the fifth leading cause of death in the United States (US). While overall CeVD-related mortality has decreased over the last two decades, mortality trends among young adults remain poorly characterized. This study aims to explore the contemporary CeVD-related mortality trends among patients <45 years old.

The CDC WONDER database was used to analyze the death data and to extract the age-adjusted mortality rates (AAMR) per 100,000 population from 1999 to 2024. CeVD was identified using ICD-10 codes I60-I69. Those deaths were included where  CeVD was either the underlying or contributing cause of death. Trends were analyzed by year, sex, race and ethnicity, and census region. Joinpoint regression was used to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Weighted average APCs were calculated and reported as AAPCs with 95% CIs to summarize mortality trends over the study period.

From 1999 to 2024, a total of 144,508 deaths were identified, with an overall average AAMR of 3.08/100,000. The overall average AAMR remained stable from 1999 to 2024 (AAPC: -0.17; p = 0.06). Men had a higher AAMR than women (3.40 vs 2.75). A significantly decreasing trend was observed among women (AAPC: -0.51; p < 0.001), whereas men showed a stable trend (AAPC: 0.16; p = 0.274). Among racial groups, non-Hispanic (NH) Black/African Americans had the highest average AAMR (6.32) and NH Asian/Pacific Islanders the lowest (2.26). By region, the South (3.61) had the highest average AAMR.

Overall mortality among young adults due to  CeVD remained stable between 1999 and 2024 in the study population. Despite this, persistent sex, racial, and regional disparities highlight the need for focused prevention strategies in certain populations.