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美国脑动脉粥样硬化相关死亡的死亡率上升(1999 - 2020年):对疾病控制与预防中心(CDC)-WONDER数据库的21年回顾性分析

Rising mortality in cerebral atherosclerosis-related deaths in the United States (1999-2020): a 21-year retrospective analysis of CDC-WONDER database.

作者信息

Shuja Muhammad Hamza, Salman Ali, Jawaid Afia, Ameen Shafin Bin, Abid Mishal, Khemane Zoya, Edhi Maliha, Fakhoury Marc, Hasan Minal

机构信息

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Department of Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

出版信息

Ann Med Surg (Lond). 2025 May 21;87(6):3542-3550. doi: 10.1097/MS9.0000000000003292. eCollection 2025 Jun.

Abstract

BACKGROUND

Cerebral Atherosclerosis-related mortality remains a major public health issue. This study analyzes trends in age-adjusted mortality rates (AAMR) for cerebral atherosclerosis deaths in the United States from 1999 to 2020.

METHODS

Mortality data from 1999 to 2020 for adults aged 25 years and older were analyzed. AAMRs were calculated, and trends were examined for the overall population, as well as by gender, urban-rural areas, race/ethnicity, and census region. Annual percentage changes (APC) were calculated to assess mortality trends.

RESULTS

A total of 146 016 deaths were recorded. The overall AAMR increased from 3.44 (95% CI: 3.36-3.53) in 1999 to 7.43 (95% CI: 7.32-7.53) in 2020. Mortality rates initially decreased from 1999 to 2006 (APC: -11.4 [95% CI: -19.7 to -7.85]), followed by a rise, with the sharpest increase from 2013 to 2016 (APC: 36.7 [95% CI: 23.0 to 45.9]). Mortality trends were similar across genders, with both males and females showing increases after an initial decline. Higher AAMRs were seen in urban areas compared to rural regions, with urban areas experiencing a steeper rise post-2013. Racial/ethnic disparities were apparent, with Hispanics showing the largest increase in mortality rates from 1999 to 2020. Regional disparities indicated the highest mortality rates in the South, with a sharp rise from 2012 to 2015.

CONCLUSION

Cerebral Atherosclerosis-related mortality rates have significantly increased from 1999 to 2020, with notable disparities across gender, race, and geographic regions. Targeted interventions are needed to address these disparities and reduce mortality, particularly in high-risk populations.

摘要

背景

脑动脉粥样硬化相关死亡率仍然是一个重大的公共卫生问题。本研究分析了1999年至2020年美国脑动脉粥样硬化死亡的年龄调整死亡率(AAMR)趋势。

方法

分析了1999年至2020年25岁及以上成年人的死亡率数据。计算了AAMR,并研究了总体人群以及按性别、城乡地区、种族/族裔和人口普查区域划分的趋势。计算年度百分比变化(APC)以评估死亡率趋势。

结果

共记录了146016例死亡。总体AAMR从1999年的3.44(95%CI:3.36 - 3.53)上升至2020年的7.43(95%CI:7.32 - 7.53)。死亡率最初从1999年至2006年下降(APC:-11.4[95%CI:-19.7至-7.85]),随后上升,2013年至2016年上升最为明显(APC:36.7[95%CI:23.0至45.9])。不同性别的死亡率趋势相似,男性和女性在最初下降后均呈现上升趋势。与农村地区相比,城市地区的AAMR更高,2013年后城市地区上升更为陡峭。种族/族裔差异明显,西班牙裔在1999年至2020年期间死亡率上升幅度最大。地区差异表明南部地区死亡率最高,2012年至201年急剧上升。

结论

1999年至2020年期间,脑动脉粥样硬化相关死亡率显著上升,在性别、种族和地理区域方面存在显著差异。需要采取有针对性的干预措施来解决这些差异并降低死亡率,特别是在高危人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b667/12140699/d93f09f44d42/ms9-87-3542-g002.jpg

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