Disparities in Peripheral Artery Disease-related Mortality in Chronic Inflammatory Disease in the United States from 1999 to 2020
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Published on: October 22, 2014
April Olson1, Hoang Nhat Pham1, Ramzi Ibrahim1
1Department of Medicine, University of Arizona Tucson, Tucson, AZ 85721, USA.
Insights
Peripheral arterial disease (PAD) mortality in chronic inflammatory disease (CID) populations remained stable but showed significant disparities. Non-Hispanic Black individuals and those in rural areas experienced disproportionately higher PAD death rates.
Area of Science:
- Cardiovascular Disease Epidemiology
- Chronic Inflammatory Diseases Research
- Public Health Disparities
Background:
- Peripheral arterial disease (PAD) signifies widespread atherosclerotic cardiovascular disease, posing a greater health burden and poorer prognosis in individuals with chronic inflammatory diseases (CID).
- Understanding temporal trends and disparities in PAD-related mortality among diverse CID populations is crucial for targeted public health interventions.
Purpose of the Study:
- To investigate the temporal trends and demographic disparities of mortality related to peripheral arterial disease (PAD) in populations with six common chronic inflammatory diseases (CID) in the US from 1999 to 2020.
Main Methods:
- Utilized US CDC multiple-cause-of-death data (1999-2020) for PAD and CID-related mortality and demographic information.
- Calculated age-adjusted mortality rates (AAMR) per 1,000,000, standardized to the 2000 US population.
- Analyzed mortality trends using Joinpoint Regression.
Main Results:
- A total of 22,175 PAD-related deaths were recorded in CID populations between 1999-2020, with overall mortality remaining stable (AAPC -0.04%).
- Mortality rates were highest in rural counties (AAMR 5.27) and among non-Hispanic Black populations (AAMR 7.06).
- PAD mortality varied by CID subtype, being highest in rheumatoid arthritis (RA) (AAMR 2.48) and lowest in psoriasis (AAMR 0.11).
Conclusions:
- Significant disparities in PAD mortality exist within CID populations, disproportionately affecting the Black population and rural communities.
- Further research using individual-level data is necessary to elucidate the factors contributing to these observed health disparities.
Introduction:
Peripheral arterial disease (PAD) is a marker of significant atherosclerotic cardiovascular disease and is associated with greater healthcare burden and worse prognosis in individuals with chronic inflammatory disease (CID). We aimed to investigate temporal trends and disparities of PAD-related mortality in populations with CID from 1999-2020 across six common CIDs (i.e., chronic viral hepatitis, human immunodeficiency virus, inflammatory bowel disease, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus).
Methods:
United States (US) PAD and CID-related mortality and demographic data from 1999- 2020 were extracted from the CDC database through the multiple-cause-of-death files. Ageadjusted mortality rates (AAMR) per 1,000,000 and 95% confidence intervals were standardized to the 2000 US population. The mortality trends were analyzed using Joinpoint Regression.
Results:
A total of 22,175 PAD-related deaths were recorded in the population with CID between 1999 and 2020. Mortality remained stable during the 22-year period (AAPC -0.04%, p=0.95) with a cumulative AAMR of 4.64. Mortality was highest in rural counties (AAMR 5.27), and among non-Hispanic Black populations (AAMR 7.06). Among the CID subtypes, PAD mortality was highest in populations with RA (AAMR 2.48) and lowest in populations with psoriasis (AAMR 0.11).
Conclusion:
Our findings highlight the disparities of PAD mortality in patients with CID, with the Black population and rural communities disproportionately affected. Further investigation with individual- level data is warranted to identify the contributing factors for the observed disparities.
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