Background: Atrial fibrillation (AF) and respiratory failure (RF) frequently co‐occur in critically ill patients, but long‐term national trends in deaths recording both remain unknown. Methods: CDC WONDER multiple‐cause‐of‐death data identified U.S. adults aged ≥ 55 years with both AF (including atrial flutter) and RF listed on death certificates from 1999 to 2024. Age‐adjusted mortality rates (AAMRs) and annual percent changes (APCs) were estimated using joinpoint regression. Sensitivity analyses included adults aged ≥ 25 years, exclusion of COVID‐19‐related deaths, and stratification by co‐listed heart failure (HF). Results: A total of 462 284 deaths listed both AF and RF. The AAMR increased roughly five‐fold (7.84 to 41.76 per 100 000), rising steadily through 2018 (APC 7.81), accelerating through 2021 (APC 18.78), and declining thereafter (APC −5.90). Excluding deaths listing COVID‐19, the 2018–2021 acceleration was not detected, and AAMRs rose through 2024 (2017–2024 APC 5.25). AAMRs for deaths without HF recorded rose over fourfold. Mean AAMRs were higher in males (26.19) than in females (19.04) and in non‐Hispanic (NH) White adults (24.06) than in other groups. The West and nonmetropolitan areas had the highest rates. The 2018–2021 surge was steepest among Hispanic (APC 25.62) and NH Black adults (APC 24.06). Conclusions: Population mortality rates for deaths recording both AF and RF increased substantially over 25 years, beginning before the COVID‐19 pandemic, persisting after excluding deaths listing COVID‐19, and occurring with and without HF recorded. These data cannot separate changes in disease occurrence from changes in diagnosis or coding.

Background: Chronic liver disease (CLD) and hypertension (HTN) are frequently co-occurring conditions with shared cardiometabolic risk factors. Our goal was to assess mortality trends associated with these co-occurring conditions on a national level. Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (1999–2024) database was used to assess deaths involving both HTN and CLD. Age-adjusted mortality rates (AAMRs) were computed per 100,000 population, and temporal mortality patterns were noted by calculating annual percentage changes (APCs) using the joinpoint regression program. Results: Between 1999 and 2024, there were 198,234 deaths representing coexisting HTN and CLD. The overall AAMR increased from 1.0 to 6.2 per 100,000, surging between 2018 and 2021 (APC: 17.66, p < 0.001) before stabilizing through 2024 (APC: 0.44, p = 0.51). The AAMRs were higher for males than females (8.2 vs. 4.4 in 2024). The non-Hispanic American Indian population had the highest peak AAMR (20.8 in 2021). Mortality was rising faster in non-metropolitan than metropolitan areas. Subgroup analysis by age showed a dose–response relationship, with AAMRs being the highest among the 85+ (25.8) group. Notably, while mortality for ages 65–74 plateaued after 2021 (APC: 1.35, p = 0.08), it continued to rise significantly for ages 75–84 (APC: 5.04, p = 0.009) and 85+ (APC: 13.75, p < 0.001). Conclusions: The mortality associated with CLD and HTN increased significantly between 1999 and 2024 and is highly inequitable with respect to rural communities, specific ethnoracial groups, and adults over 75. Our findings highlight the need for integrated care pathways and interventions in cardiometabolic-hepatology for highly vulnerable populations.