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. 2022 Aug 2;11(15):e025276.
doi: 10.1161/JAHA.121.025276. Epub 2022 Jul 19.

Proportionate and Absolute Vascular Disease Mortality by Race and Sex in the United States From 1999 to 2019

Scott E Janus  1   2 , Tarek Chami  3 , Haytham Mously  2 , Jamal Hajjari  1   2 , Tarek Hammad  1   2 , Yulanka Castro-Dominguez  1   2 , Foluso Fakorede  4 , Khendi White Solaru  1   2 , Mehdi H Shishehbor  1   2 , Sadeer G Al-Kindi  1   2 , Jun Li  1   2
Affiliations

Proportionate and Absolute Vascular Disease Mortality by Race and Sex in the United States From 1999 to 2019

Scott E Janus et al. J Am Heart Assoc. .

Abstract

Background Despite the known significant morbidity and mortality associated with cardiovascular disease and peripheral vascular disease (PVD), contemporary data describing racial demographics in PVD mortality are scarce. Methods and Results Using the multiple causes of death file from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research, we analyzed the trends of age-adjusted mortality (AAMR) for PVD and its subtypes (aortic aneurysm/dissection, arterial thrombosis, venous thrombosis/disease, pulmonary embolism), by race and sex between 1999 and 2019. Of the 17 826 871 deaths attributed to cardiovascular disease, a total of 888 187 (5.0%) PVD deaths were analyzed during the study period (12.4% Black, 85.6% White). Between 1999 and 2019, AAMR for PVD decreased by 52% (24.8-11.8 per 100 000 people) in the overall population. Despite a decrease in the overall mortality across all race and sex groups, Black men and Black women continued to have higher mortality for PVD (1.5×), aortic dissection (1.8×), arterial thrombosis (1.3×), and venous thrombosis/disease (2.0×) mortality compared with White men and White women in 2019. While there was a 53% decrease in PVD among White individuals (AAMR 24.5-11.5 per 100 000), there was only a 43% decrease (30.0-17.1) in PVD AAMR in Black individuals between 1999 and 2019. The ratio of PVD AAMR increased from 1.2 (1999) to 1.5 (2019) in Black men/White men and from to 1.3 (1999) to 1.5 (2019) in Black women/White women. Similar trends were noted in aortic dissection (Black men/White men, 1.2-1.8; and Black women/White women, 1.5-1.7), arterial thrombosis (Black men/White men, 1.0-1.3; and Black women/White women, 0.9-1.3), and venous thrombosis/disease (Black men/White men, 1.7-1.8; and Black women/White women, 1.7-2.0). Conclusions In this retrospective review of death certificate data in the United States, we demonstrate continued significant disparities between Black and White populations in PVD mortality and its subtypes. Future studies should investigate etiologies and social determinants of PVD mortality.

Keywords: PVD; disparities; mortality; race; vascular.

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Figures

Figure 1
Figure 1. Overall percentage of mortality (%) by age group, in patients aged ≥18 years, 1999–2019.
Figure 2
Figure 2. Trend of vascular disease age‐adjusted mortality rates and ratio.
A, Overall trend vascular disease age‐adjusted mortality rates. B, Overall trend of vascular disease mortality ratio by race and sex. B/W indicates Black/White.
Figure 3
Figure 3. Trend of aortic dissection age‐adjusted mortality rates and ratio.
A, Overall trend aortic dissection age‐adjusted mortality rates. B, Overall trend of aortic dissection mortality ratio by race and sex. B/W indicates Black/White.
Figure 4
Figure 4. Trend of arterial thrombosis age‐adjusted mortality rates and ratio.
A, Overall trend arterial thrombosis age‐adjusted mortality rates. B, Overall arterial thrombosis mortality ratio by race and sex. B/W indicates Black/White.
Figure 5
Figure 5. Trend of venous thrombosis/disease age adjusted mortality rates and ratio.
A, Overall trend venous thrombosis/disease age‐adjusted mortality rates. B, Overall venous thrombosis/disease mortality ratio by race and sex. B/W indicates Black/White.
See this image and copyright information in PMC

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