Usman Muhammad Shariq, Jamil Adeena, Chunawala Zainali, Alam Mahboob, Nambi Vijay, Abushamat Layla A, Misra Arunima, Virani Salim S, Ballantyne Christie M, Taffet George E, Nasir Khurram, Goel Sachin, Al-Kindi Sadeer, Butler Javed, Minhas Abdul Mannan Khan
Department of Medicine, UT Southwestern Medical Center, Dallas, Texas.
Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Tex Heart Inst J. 2024 Dec 19;51(2):e248426. doi: 10.14503/THIJ-24-8426. eCollection 2024 Jul-Dec.
Cardiovascular disease (CVD) is associated with high mortality in the United States, but the burden of CVD mortality is unevenly distributed between demographic and geographic subgroups, with poor characterization of state-specific trends. In this study, the disparities in CVD-related mortality trends in Texas and the United States from 1999 to 2019 were assessed.
Trends in CVD-related mortality were evaluated through analysis of the Multiple Causes of Death Files from the National Center for Health Statistics. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population with associated annual percentage changes were determined. Joinpoint regression was used to assess trends in the CVD-related mortality rates.
Between 1999 and 2019, 29,455,193 CVD-related deaths were reported in the United States, of which 1,937,166 occurred in Texas. After an initial decline in the overall AAMR in Texas (annual percentage change, -2.5 [95% CI, -2.8 to -2.1]), a steady level was maintained from 2009 to 2019 (annual percentage change, 0.2 [95% CI, -0.5 to 0.2]). In the United States, after initial decline, AAMR plateaued from 2011 to 2019. Overall, CVD-related AAMR was slightly higher in Texas than in the overall United States (AAMR, 674.1 [95% CI, 673.2-675.1] vs 654 [95% CI, 653.8-654.3]). Men, non-Hispanic Black people, and people 85 years of age and older had the highest AAMRs in Texas and nationwide. Nonmetropolitan areas, both nationally and in Texas, consistently had higher mortality rates. The AAMRs also varied significantly by county within Texas.
Despite an initial period of decline, CVD-related mortality rates have plateaued in Texas and the United States. Higher AAMRs were observed in Texas than in the overall United States. Prevalent disparities also exist based on demographic and geographic subgroups.
在美国，心血管疾病（CVD）与高死亡率相关，但CVD死亡率的负担在人口统计学和地理亚组之间分布不均，且缺乏对各州特定趋势的详细描述。在本研究中，评估了1999年至2019年得克萨斯州和美国CVD相关死亡率趋势的差异。
通过分析国家卫生统计中心的多死因档案来评估CVD相关死亡率的趋势。确定了每10万人口的粗死亡率和年龄调整死亡率（AAMR）以及相关的年度百分比变化。采用Joinpoint回归分析评估CVD相关死亡率的趋势。
1999年至2019年期间，美国报告了29455193例CVD相关死亡，其中1937166例发生在得克萨斯州。得克萨斯州总体AAMR最初下降（年度百分比变化，-2.5[95%CI，-2.8至-2.1]）后，2009年至2019年保持稳定水平（年度百分比变化，0.2[95%CI，-0.5至0.2]）。在美国，最初下降后，AAMR从2011年至2019年趋于平稳。总体而言，得克萨斯州CVD相关AAMR略高于美国总体水平（AAMR，674.1[95%CI，673.2 - 675.1]对654[95%CI，653.8 - 654.3]）。男性、非西班牙裔黑人以及85岁及以上人群在得克萨斯州和全国的AAMR最高。在全国和得克萨斯州，非都市地区的死亡率一直较高。得克萨斯州各县的AAMR也存在显著差异。
尽管有最初的下降期，但得克萨斯州和美国的CVD相关死亡率已趋于平稳。得克萨斯州的AAMR高于美国总体水平。在人口统计学和地理亚组方面也存在普遍差异。
