Trends in circulatory-system mortality among adults with arthrosis in the U.S

Arthrosis is prevalent in later life and commonly coexists with cardiovascular and other circulatory conditions. We quantified U.S. mortality in which diseases of the circulatory system (ICD-10: I00-I99) were the underlying cause of death, and arthrosis (M15-M19) was recorded as a contributing cause among adults aged ≥ 55 years. We used the CDC WONDER multiple-cause-of-death database (1999-2023). Age-adjusted mortality rates (AAMRs; standardised to the 2000 U.S. population) and age-specific crude mortality rates were calculated. Temporal trends were evaluated using joinpoint regression to estimate the average annual percent change (AAPC). Analyses were stratified by sex, age group, race/ethnicity, census region, urbanisation, and state. Deaths decreased from 7,290 in 1999 to 2,022 in 2023 (- 72.26%). The AAMR declined from 12.67 to 2.27 per 100,000, with an AAPC of - 6.87% (95% CI: -7.64 to - 6.09); Joinpoint regression revealed a non-linear decline with distinct temporal phases separated by identifiable inflection points. In 2023, the AAMR was higher in females than males (2.63 vs. 1.72 per 100,000) and was concentrated among adults aged ≥ 85 years (21.10 per 100,000). Nonmetropolitan areas had higher AAMRs than metropolitan areas; however, direct comparisons were restricted to 2020, the most recent year with available estimates for both categories. Hispanic (1.34) and non-Hispanic Other (1.02) groups had lower AAMRs than non-Hispanic Black (2.50) and non-Hispanic White (2.48) groups. State-level AAMRs in 2023 ranged from 1.17 (Arizona) to 5.83 (Oregon). U.S. circulatory-system mortality with coexisting arthrosis declined substantially from 1999 to 2023; however, marked demographic and geographic heterogeneity persisted. Continued surveillance is warranted and may inform cardiovascular risk assessment in older adults with arthrosis.