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We aimed to investigate PE mortality trends from 1968\u20132023 and forecast rates through 2040 in the U.S. We analyzed CDC WONDER death certificates for adults\u2009\u2265\u200925\u00a0years. Age-adjusted mortality rates (AAMRs), annual percent changes (APCs) were used to analyse trends and Auto-ARIMA\/Prophet forecasting models were used for future projections, all stratified by sex, age, race, and contributing cause of death. From 1968\u20132023, 516,187 PE deaths occurred, with a mean AAMR of 6.06 per 100,000 (AAPC -1.85). Mean AAMRs were 6.76 in men and 5.57 in women. By age, rates averaged 0.98 for adults 25\u201344\u00a0years, 3.96 for 45\u201364\u00a0years, and 21.73 for\u2009\u2265\u200965\u00a0years. Black adults had a mean AAMR of 10.87 versus 5.76 in White adults. From 1999\u20132023, PE death linked to Coronary Artery Disease, COPD, infection, and diabetes declined, while PE death linked to hypertension rose and heart failure related PE plateaued. Forecasts project an overall AAMR of 3.63 by 2040 (2.32 in men, 3.25 in women), with the highest predicted rate of 9.24 among adults\u2009\u2265\u200965\u00a0years. Projected racial AAMRs are 3.70 in White and 7.71 in Black individuals. Hypertension and heart failure linked rates are expected to rise further. Despite a sustained decline in PE death since 1968, persistent racial gaps, aging populations, and rising hypertension and heart-failure related PE threaten progress, highlighting the need for targeted prevention and equitable cardiovascular risk management.<\/jats:p>","DOI":"10.1007\/s11239-026-03281-9","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T10:48:26Z","timestamp":1779619706000},"page":"1985-1995","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends and Future Projections of P ulmonary Embolism and Top Contributing Causes of death in the United States, 1968\u20132040: insights from the CDC WONDER database"],"prefix":"10.1007","volume":"59","author":[{"given":"Saifullah","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faizan","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiza","family":"Ahsan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheer","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Khalid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Sajjad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Baig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Ahmed","family":"Waqas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faizan","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"3281_CR1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001306","author":"EA Takahashi","year":"2025","unstructured":"Takahashi EA, Sista AK, Addison D, Bikdeli B, Bishay VL, Gu S et al (2025) Disparities in current pulmonary embolism management and Outcomes: a scientific statement from the American Heart Association. 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Dr Greene has received research support from the Duke University Department of Medicine Chair\u2019s Research Award, American Heart Association, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cytokinetics, Merck, Novartis, Otsuka, Pfizer, and Sanofi; has served on advisory boards or as consultant for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Chugai, Corcept Therapeutics, Corteria Pharmaceuticals, CSL Vifor, Cytokinetics, Idorsia, Lexicon, Lilly, Merck, Novo Nordisk, Otsuka, Roche Diagnostics, Sanofi, scPharmaceuticals, Sumitomo, and Tricog Health; and has received speaker fees from AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Lexicon, Novartis, Novo Nordisk, and Roche Diagnostics. The other authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}