Demographic and regional trends of peripheral artery disease-related mortality in the United States, 2000 to 2019

Abstract

Introduction: Peripheral artery disease (PAD) is a common progressive atherosclerotic disease associated with significant morbidity and mortality in the US; however, data regarding PAD-related mortality trends are limited. This study aims to characterize contemporary trends in mortality across sociodemographic and regional groups. Methods: The Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) was queried for data regarding PAD-related deaths from 2000 to 2019 in the overall sample and different demographic (age, sex, race/ethnicity) and regional (state, urban–rural) subgroups. Crude and age-adjusted mortality rates (CMR and AAMR, respectively) per 100,000 people were calculated. Associated annual percentage changes (APC) were computed using Joinpoint Regression Program Version 4.9.0.0 trend analysis software. Results: Between 2000 and 2019, a total of 1,959,050 PAD-related deaths occurred in the study population. Overall, AAMR decreased from 72.8 per 100,000 in 2000 to 32.35 per 100,000 in 2019 with initially decreasing APCs followed by no significant decline from 2016 to 2019. Most demographic and regional subgroups showed initial declines in AAMRs during the study period, with many groups exhibiting no change in mortality in recent years. However, men, non-Hispanic (NH) Black or African American individuals, people aged ⩾ 85 years, and rural counties were associated with the highest AAMRs of their respective subgroups. Notably, there was an increase in crude mortality rate among individuals 25–39 years of age from 2009 to 2019. Conclusion: Despite initial improvement, PAD-related mortality has remained stagnant in recent years. Disparities have persisted across several demographic and regional groups, requiring further investigation.

The problem of disparities in vascular health

“…They also identified that men, Black Americans, and those in rural counties had the highest adjusted mortality rates. 10…”

“…8 This higher risk of PAD-related mortality is shown in the work of Dicks et al, 9 where utilizing NHANES data found that Black individuals presented with more premature PAD, had a higher burden of SDoH, and those with concomitant coronary artery disease (CAD) had higher rates of age-adjusted mortality compared to their White counterparts. 9 Issa et al 10 show us that PAD-related mortality has decreased over the last two decades, with a plateau over the last several years. They also identified that men, Black Americans, and those in rural counties had the highest adjusted mortality rates.…”

“…They also identified that men, Black Americans, and those in rural counties had the highest adjusted mortality rates. 10 Hispanics have historically been underrepresented in cardiovascular studies, which is important to highlight when a study includes a representative cohort of Hispanic adults. Snyder et al 11 report data on 1265 patients with confirmed pulmonary embolism (PE) in which 37% identified as Hispanic or Latino from a single institution.…”