Demographic and regional trends of mortality in patients with cardiovascular disease and liver cirrhosis in the United States between 1999 and 2019

Objectives

National estimates of deaths related to cardiovascular disease (CVD) and liver cirrhosis remain ambiguous. The purpose of this study was to observe the contemporary trends in CVD and liver cirrhosis-related mortality in the United States.

Methods

We evaluated the trends using the CDC WONDER database to identify adults with CVD and liver cirrhosis associated death between 1999 and 2019. Age-adjusted mortality rates (AAMRs) per 100,000 population and associated average annual percent changes (AAPCs) with 95 % confidence intervals (CIs) were assessed using Joinpoint regression.

Results

Between 1999 and 2019, a total of 374,090 deaths occurred due to CVD and liver cirrhosis. In the overall population, the AAMR increased from 7.54 (95 % CI 7.41–7.67) in 1999 to 10.55 (95 % CI 10.43–10.68) with an AAPC of 1.68 (95 % CI 1.59–1.77). The highest AAMRs were seen in males, Native Americans, and those living in West. A substantial increase in AAMRs was observed in all age groups with the highest seen in 70–84 year group. Moreover, non-metropolitan cities had a much higher increase in AAMRs compared to large metropolitan cities. The highest AAMRs were observed in California whereas the lowest in Utah.

Conclusion

There is a rising trend of CVD and liver cirrhosis-associated mortality in all groups. However, disparities continue to exist in association with gender, race, age, and geographical region. Future trials should address alleviating CVD and liver cirrhosis-related deaths in all population groups equitably.