■心脏瓣膜病(VHD)代表了一系列的心脏病,包括瓣膜狭窄,瓣膜反流,或影响单个或多个瓣膜的混合病变。VHD的严重程度已成为美国老年人群中心血管(CV)发病率和死亡率的主要原因(U.S).
■评估1999年至2019年美国老年人口与VHD相关的死亡率的时间趋势。
■我们利用CDCWONDER数据库对1999年至2019年≥75的成年人的VHD死亡率,使用ICD-10代码。计算了每100,000人的年龄调整死亡率(AAMR)以及相关的年度变化百分比(APC)。Joinpoint回归用于评估人口统计的总体趋势和趋势,地理,和瓣膜疾病亚组的类型。
■从1999年到2019年,老年人共发现666,765例VHD死亡。AAMR最初下降到2007年,APC:0.62,95%CI(-1.66-0.33),2014年之前保持稳定,2019年之前大幅下降(APC:1.47,95%CI[-2.24-1.04],P<0.0001)。与女性相比,男性的AAMR始终较高(总体AAMR男性:173.6;女性:138.2)。AAMR在白人中最高(166.5),其次是美洲印第安人或阿拉斯加原住民(93.8)西班牙裔或拉丁裔(80.7),黑人或非裔美国人(74.1),最后是亚洲或太平洋岛民(73.4)。非大都市地区与VHD相关的死亡的AAMR高于大都市地区(总体AAMR分别为160.5和149.5)。全州范围的AAMR各不相同,佛蒙特州最高,为324.2(95%CI[313.0-335.4],P<0.0001),密西西比州最低,为88.0(95%CI[85.0-91.0],P<0.0001)。与风湿性或二尖瓣疾病相比,≥75岁的成年人非风湿性和主动脉瓣疾病的死亡率更高。
■我们的研究表明,从1999年到2019年,美国VHD死亡率有所下降,但发现性别差异持续存在。种族,年龄,区域,和VHD类型。需要有针对性的预防和早期诊断政策来解决这些不平等。
UNASSIGNED: Valvular heart disease (VHD) represents a spectrum of cardiac conditions, including valvular stenosis, valvular regurgitation, or mixed lesions affecting single or multiple valves. The severity of VHD has emerged as a major cause of cardiovascular (CV) morbidity and
mortality among the older population in the United States (U.S).
UNASSIGNED: To evaluate temporal trends in
mortality associated with VHD in the elderly U.S population between 1999 and 2019.
UNASSIGNED: We utilized the CDC WONDER database for VHD
mortality in adults ≥75 from 1999 to 2019, using ICD-10 codes. Age-adjusted
mortality rates (AAMR) per 100,000 people with associated annual percentage change (APC) were calculated. Joinpoint regression was used to assess the overall trends and trends for demographic, geographic, and type of valvular disease subgroups.
UNASSIGNED: A total of 666,765 VHD deaths in older adults from 1999 to 2019 was identified, with an initial decline in AAMR until 2007 with an APC: 0.62, 95 % CI (-1.66-0.33), stability until 2014, and a significant decrease until 2019 (APC: 1.47, 95 % CI [-2.24-1.04], P < 0.0001). Men consistently had higher AAMRs compared to women (overall AAMR men: 173.6; women: 138.2). The AAMRs were found to be highest in the White (166.5), followed by American Indian or Alaska Native population at (93.8) Hispanic or Latino at (80.7), Black or African American populations at (74.1) and lastly Asian or Pacific Islander (73.4). Non-metropolitan areas manifested higher AAMRs for deaths related to VHD than metropolitan areas (overall AAMRs 160.5 vs 149.5) respectively. State-wide AAMRs varied, with the highest in Vermont at 324.2 (95 % CI [313.0-335.4], P < 0.0001) and the lowest in Mississippi at 88.0 (95 % CI [85.0-91.0], P < 0.0001). Non-rheumatic and aortic valve disorders in adults ≥75 years had higher mortality rates compared to rheumatic or mitral valve conditions in those <75 years.
UNASSIGNED: Our study showed a decline in U.S. VHD
mortality from 1999 to 2019 but found persistent disparities by gender, race, age, region, and VHD type. Targeted policies for prevention and early diagnosis are needed to address these inequalities.