{
  "abstract": "Introduction Aortic disease and cerebrovascular disease remain major contributors to cardiovascular mortality in the United States, with evolving temporal patterns and persistent demographic and geographic disparities. Contemporary population-level evaluations examining combined trends across these vascular conditions are limited. We assessed long-term mortality trends and subgroup differences among U.S. adults aged ≥35 years.Methods We conducted a population-based analysis using the CDC Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause-of-Death database from 1999–2020. Deaths involving aortic disease (ICD-10 I71.0–I71.9) and cerebrovascular disease (I60–I69) were included. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using direct standardization to the 2000 U.S. standard population. Temporal trends were evaluated using Joinpoint regression to estimate annual percent change (APC) with 95% confidence intervals (CI) and p-values. Analyses were stratified by age, sex, race/ethnicity, urban–rural classification, and state.Results A total of 27,044 deaths related to aortic disease and cerebrovascular disease were identified. National AAMRs declined from 1.0 in 1999 to 0.6 in 2017 (APC: −0.16; 95% CI: −3.88 to 3.22; p=0.95), followed by a significant increase through 2020 (AAMR 0.8; APC: 9.43; 95% CI: 4.44–16.22; p<0.01). Males consistently demonstrated higher mortality than females (overall AAMR: 1.1 vs 0.5). Among males, mortality declined from 1999–2011 (APC: −5.69; 95% CI: −7.28 to −4.69; p<0.01) before increasing through 2020 (APC: 2.53; 95% CI: 0.38–6.55; p=0.02). Females experienced a significant decline until 2015 (APC: −3.03; 95% CI: −7.16 to −2.15; p=0.02), followed by a non-significant rise thereafter.By race/ethnicity, the highest overall AAMRs were observed among non-Hispanic Black and White populations (0.7 each), followed by non-Hispanic Asian or Pacific Islanders (0.6) and Hispanics (0.3). Urbanization analyses revealed the highest AAMRs in micropolitan and non-core areas (0.9), compared with large metropolitan areas (0.6). State-level analysis showed that states above or equal to the the 90th percentile of AAMRs (1.0) included Minnesota, North Dakota, West Virginia, Hawaii, Mississippi, Ohio, Oregon, Vermont, Rhode Island, Washington, and Wyoming, with AAMRs ranging from approximately 1.0–1.2 per 100,000 (figures 1 and 2).Conclusions Although mortality from aortic and cerebrovascular disease declined for much of the study period, a concerning reversal has occurred in recent years, particularly among males, racial minorities, and residents of rural areas and high-burden states. These findings highlight the need for targeted prevention strategies, improved access to vascular care, and geographically tailored public health interventions.Abstract 284 Figure 1Annual age adjusted rate for aortic disease and cerebrovascular disease stratified in the U.S, 1999–2020Abstract 284 Figure 2Age adjusted rate for aortic disease and cerebrovascular disease stratified against gender in the U.S, 1999–2020",
  "authors": [
    {
      "affiliations": [
        "University College of Medicine and Dentistry, Lahore, Pakistan"
      ],
      "name": "Suleman Saeed"
    },
    {
      "affiliations": [
        "University College of Medicine and Dentistry, Lahore, Pakistan"
      ],
      "name": "Hamid Bin Tariq"
    },
    {
      "affiliations": [
        "Liaquat University of Medical and Health Sciences, Karachi, Pakistan"
      ],
      "name": "Sassi Ashraf Ali Abbasi"
    },
    {
      "affiliations": [
        "University College of Medicine and Dentistry, Lahore, Pakistan"
      ],
      "name": "Taha Shahbaz"
    },
    {
      "affiliations": [
        "Foundation University Medical College, Islamabad, Pakistan"
      ],
      "name": "Izza Zahra"
    },
    {
      "affiliations": [
        "Ameer-ud-Din Medical College, Lahore, Pakistan"
      ],
      "name": "Mehmood Hassan"
    },
    {
      "affiliations": [
        "Dow University of Health Sciences, Karachi, Pakistan"
      ],
      "name": "Mirza Mehmood Ali Baig"
    },
    {
      "affiliations": [
        "Foundation University Medical College, Islamabad, Pakistan"
      ],
      "name": "Haider Imran"
    },
    {
      "affiliations": [
        "Fatima Jinnah Medical University, Lahore, Pakistan"
      ],
      "name": "Tuba Shakoor"
    },
    {
      "affiliations": [
        "Khyber Medical University, Peshawar, Pakistan"
      ],
      "name": "Haseeb Sadaqat"
    },
    {
      "affiliations": [
        "Saidu Medical College, Sawat, Pakistan"
      ],
      "name": "Maria Sadaqat"
    },
    {
      "affiliations": [
        "Rawalpindi Medical College, Rawalpindi, Pakistan"
      ],
      "name": "Umair Mushtaq"
    }
  ],
  "title": "284 Trends in mortality from aortic disease and cerebrovascular disease in the United States: a CDC analysis, 1999–2020",
  "uid": "e22d4ab1-d7f6-5c86-8eb0-db69a9c92da6"
}