Divergent Burden Patterns of Major Arterial Cardiovascular Diseases Across US States

Area of Science:

• Cardiovascular Disease Epidemiology
• Public Health Surveillance
• Arterial Pathology Burden Assessment

Background:

• Stroke, ischemic heart disease (IHD), and peripheral artery disease (PAD) are key systemic arterial diseases.
• Previous studies analyzed these conditions in isolation, limiting comparative burden assessment across US states.
• Understanding the distinct and overlapping burdens is crucial for public health strategies.

Purpose of the Study:

• To comparatively analyze the burden of stroke, IHD, and PAD across US states.
• To characterize national trends, age-specific patterns, and state-level variations from 1990 to 2021.
• To examine correlations between disease burden and the Sociodemographic Index.

Main Methods:

• Utilized Global Burden of Disease (GBD) 2021 estimates for prevalence, incidence, deaths, and disability metrics.
• Quantified disease burden for stroke, IHD, and PAD across US states between 1990 and 2021.
• Employed age-standardized rates, spatial mapping, annual percentage change analysis, and correlation with the Sociodemographic Index.

Main Results:

• In 2021, IHD had the highest mortality burden, followed by stroke, while PAD had the highest incidence but lower direct mortality.
• Stroke presented the greatest nonfatal burden (years lived with disability).
• All three diseases showed declining age-standardized death rates from 1990-2021, with IHD declining most rapidly and all inversely correlated with the Sociodemographic Index.

Conclusions:

• IHD, stroke, and PAD exhibit distinct burden profiles in the US, with IHD dominating mortality and stroke contributing significantly to fatal and disabling outcomes.
• PAD demonstrates high incidence but lower direct mortality based on GBD cause-specific estimates.
• Disease-specific surveillance and targeted prevention strategies are essential for managing these major arterial cardiovascular diseases.