Evolving Trends and Health Disparities in Peripheral Artery Disease in the United States (1999-2024).

Abstract

Peripheral artery disease (PAD) is a common progressive atherosclerotic condition that significantly affects morbidity and mortality in the United States. However, data on PAD-related mortality trends are limited. This study investigates contemporary mortality trends across various sociodemographic and regional factor groups. CDC-WONDER (1999-2024) data were analyzed to assess PAD-related mortality in patients aged ≥25. Using the Joinpoint regression analysis, we calculated age-adjusted mortality rates (AAMR) per 100,000 patients and average annual percentage changes (AAPCs) to analyze the mortality trends. PAD accounted for 793,773 deaths between 1999 and 2024. The AAMRs decreased from 18.0 in 1999 to 13.0 in 2024 (AAPC: -1.37). The most significant decline occurred from 1999 to 2010 [annual percent change (APC): -3.46] and 2021 to 2024 (APC: -3.96). However, there was a concerning rise from 2018 to 2021 (APC: 5.42), possibly due to the pandemic, all with P < 0.01. Disparities are evident, as men have higher AAMRs than women (16.8 vs. 11.4), and non-Hispanic (NH) Black individuals are at the highest risk (AAMR: 28.8), followed by NH Whites (AAMR: 13.6). Regionally, West Virginia reports the highest AAMR at 18.5, in contrast to Utah's lowest rate of 7.1. Moreover, rural areas exhibited higher AAMRs than urban settings (15.2 vs. 13.2). In the United States, mortality trends among patients with PAD have significantly declined; however, from 2018 to 2021, these trends experienced a reversal, likely influenced by the COVID-19 pandemic. Enhancing healthcare access and implementing targeted interventions can mitigate these disparities and improve patient outcomes.