美国烟草使用者中风相关死亡率趋势：对CDC WONDER数据库国家数据的21年回顾性分析

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-21 DOI:10.1016/j.jstrokecerebrovasdis.2025.108436

Wajeeh Hassan , Rayyan Nabi , Shree Rath , Areej Javeid , Dua Ali , Bakhtawar Haseeb , Javeria Javeid , Sabahat Ul Ain Munir Abbasi , Syed Hashim Ali Inam , Edwin Serrano , Raheel Ahmed , Paul Ferguson

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引用次数: 0

摘要

中风是死亡的主要原因，吸烟是一个重要的可改变的危险因素。本研究使用CDC WONDER数据分析了1999年至2023年美国烟草相关中风死亡率的趋势。方法纳入年龄≥25岁的脑血管疾病（ICD-10 I60-I69）和烟草相关疾病（ICD-10 F17.0-F17.9）为潜在死亡原因的成年人。每10万人的年龄调整死亡率（AAMRs）是根据2000年美国标准人口计算的。发病率按性别、种族/民族、城乡状况、地理区域、州和10岁年龄组分层。使用连接点回归来估计死亡率趋势随时间的年和年均百分比变化（APC和AAPC）。结果1999 - 2023年共发生157,916例与烟草相关的脑卒中死亡。aamr从1999年的0.41 （95% CI: 0.38-0.44）增加到2023年的3.80 (95% CI: 3.73-3.87)（平均APC: 9.65%, p < 0.0001）。男性的aamr（3.52）高于女性（2.02），尽管女性在1999年至2005年期间经历了更急剧的增长（APC: 41.3%, 95% CI: 30.2-53.3）。非西班牙裔黑人的平均AAMR最高（3.13），其次是非西班牙裔白人（2.83）和西班牙裔（1.31）。农村地区（3.84人）超过了首都地区（2.38人）。从地区来看，中西部地区的AAMR最高，为3.57；各州的税率从俄勒冈州（8.0）到加利福尼亚州（0.31）不等。按年龄分，75岁及以上人群粗率最高，尤其是85岁以上人群，呈持续上升趋势（APC: 4.29%, 95% CI: 3.47 ~ 5.11）。结论烟草相关卒中死亡率的差异在人口统计学和地理亚群中不断扩大，强调了有针对性的预防策略、卒中护理的公平获取和提高健康素养的必要性。

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Stroke-related mortality trends among tobacco users in the U.S.: A 21-year retrospective analysis of national data from the CDC WONDER database

Introduction

Stroke is a leading cause of mortality, and tobacco use is a significant modifiable risk factor. This study analyzed trends in tobacco-associated stroke mortality in the United States from 1999 through 2023 using CDC WONDER data.

Methods

We included adults aged ≥ 25 years with cerebrovascular disease (ICD-10 I60–I69) as the underlying cause of death and tobacco-related disorders (ICD-10 F17.0–F17.9) as contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated based on the 2000 U.S. standard population. Rates were stratified by sex, race/ethnicity, urban-rural status, geographic region, state, and ten-year age groups. Joinpoint regression was used to estimate annual and average annual percent changes (APC and AAPC) in mortality trends over time.

Results

A total of 157,916 tobacco-related stroke deaths occurred from 1999 to 2023. The AAMRs increased from 0.41 (95 % CI: 0.38–0.44) in 1999 to 3.80 (95 % CI: 3.73–3.87) in 2023 (average APC: 9.65 %, p < 0.0001). Males had higher AAMRs (3.52) than females (2.02), although females experienced a steeper increase from 1999 to 2005 (APC: 41.3 %, 95 % CI: 30.2–53.3). Non-Hispanic Blacks had the highest average AAMR (3.13), followed by Non-Hispanic Whites (2.83) and Hispanics (1.31). Rural areas (3.84) exceeded metropolitan regions (2.38). Regionally, the Midwest had the highest AAMR (3.57); state rates ranged from Oregon (8.0) to California (0.31). By age, the highest crude rates occurred in those aged 75 years and older, particularly in the 85+ group, which showed a sustained upward trend (APC: 4.29 %, 95 % CI: 3.47–5.11).

Conclusion

Disparities in tobacco-associated stroke mortality are increasing across demographic and geographic subgroups, underscoring the need for targeted prevention strategies, equitable access to stroke care, and enhanced health literacy.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.