Proportionate and Absolute Vascular Disease Mortality by Race and Sex in the United States From 1999 to 2019

Abstract

BACKGROUND: Despite the known significant morbidity and mortality associated with cardiovascular disease and peripheralvascular disease (PVD), contemporary data describing racial demographics in PVD mortality are scarce.METHODS AND RESULTS: Using the multiple causes of death file from the Centers for Disease Control and Prevention’s Wide-RangingOnline Data for Epidemiologic Research, we analyzed the trends of age-adjustedmortality (AAMR) for PVD and its subtypes (aorticaneurysm/dissection, arterial thrombosis, venous thrombosis/disease, pulmonary embolism), by race and sex between 1999 and2019. Of the 17 826 871 deaths attributed to cardiovascular disease, a total of 888 187 (5.0%) PVD deaths were analyzed duringthe study period (12.4% Black, 85.6% White). Between 1999 and 2019, AAMR for PVD decreased by 52% (24.8–11.8per 100 000people) in the overall population. Despite a decrease in the overall mortality across all race and sex groups, Black men and Blackwomen continued to have higher mortality for PVD (1.5×), aortic dissection (1.8×), arterial thrombosis (1.3×), and venous thrombosis/disease (2.0×) mortality compared with White men and White women in 2019. While there was a 53% decrease in PVD amongWhite individuals (AAMR 24.5–11.5per 100 000), there was only a 43% decrease (30.0–17.1)in PVD AAMR in Black individualsbetween 1999 and 2019. The ratio of PVD AAMR increased from 1.2 (1999) to 1.5 (2019) in Black men/White men and from to 1.3(1999) to 1.5 (2019) in Black women/White women. Similar trends were noted in aortic dissection (Black men/White men, 1.2–1.8;and Black women/White women, 1.5–1.7),arterial thrombosis (Black men/White men, 1.0–1.3;and Black women/White women,0.9–1.3),and venous thrombosis/disease (Black men/White men, 1.7–1.8;and Black women/White women, 1.7–2.0).CONCLUSIONS: In this retrospective review of death certificate data in the United States, we demonstrate continued significantdisparities between Black and White populations in PVD mortality and its subtypes. Future studies should investigate etiologiesand social determinants of PVD mortality.