Osteoporosis and Cardiovascular Disease: Mortality Trends Among Adults in the United States From 1999 to 2020

Document Type

Conference Proceeding

Publication Date

9-2024

Publication Title

Arthritis & Rheumatology

Abstract

Background/Purpose: Osteoporosis and cardiovascular disease (CVD) represent significant public health concerns. This study investigates the trends and demographic disparities in mortality due to osteoporosis and CVD. The studied population was adults aged 25 and older in the United States from 1999 to 2020.

Methods: We conducted a retrospective analysis using data from the CDC-WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percentage Change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions.

Results: Between 1999 and 2020, osteoporosis and CVD accounted for 171,698 deaths among adults aged 25+ years in the U.S. Deaths primarily occurred in nursing homes/long-term care facilities (45.1%), followed by medical facilities (24.5%). The overall AAMR for osteoporosis and CVD-related deaths decreased from 5.0 in 1999 to 2.3 in 2020, with an AAPC of -4.68 (95% CI: -5.21 to -4.28, p < 0.000001). AAMRs initially increased slightly from 1999 to 2004 (APC: 0.95, p = 0.314737) but then significantly declined from 2004 to 2020 (APC: -6.37, p < 0.000001).
Adult women exhibited substantially higher AAMRs compared to men (women: 5.0; men: 1.1). The AAMR of both men and women decreased from 1999 till 2020, with the decrease more prominent in men [Men: AAPC: -4.75 (CI: -5.27 to -4.35) (p-value < 0.000001); Women: AAPC: -4.43, (CI: -4.88 to -4.09) (p-value < 0.000001)]. The highest AAMRs were among Whites (4.0), followed by Asians or Pacific Islanders (2.4), American Indians or Alaska Natives (2.1), Hispanics (1.8), and Blacks (1.1). All racial groups experienced decreases in AAMRs, most notably Whites (AAPC: -4.59, p < 0.000001). Geographically, AAMRs ranged from 1.1 in Louisiana to 13.8 in Vermont, with the Midwest having the highest regional AAMR (4.5). Nonmetropolitan areas had higher AAMRs than metropolitan areas (nonmetropolitan: 4.4; metropolitan: 3.4), with significant decreases observed in both (metropolitan AAPC: -4.63, p < 0.000001; nonmetropolitan AAPC: -4.18, p < 0.000001).

Conclusion: This analysis reveals a significant decline in mortality rates due to osteoporosis and CVD among adults in the U.S. over the past two decades. Results also indicate demographic and geographic disparities across the U.S. These disparities in AAMRs underscore the need for targeted interventions to address the specific healthcare needs of these populations.

Volume

76

Issue

S9

First Page

2116

Comments

American College of Rheumatology ACR Convergence 2024 Annual Meeting, November 14-29, 2024, Washington, DC

Last Page

2117

DOI

10.1002/art.42992

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