Risultati per: GPG: Versione 5.6.2.1 (Aprile 2021)

Circulation, Volume 150, Issue Suppl_1, Page A4127417-A4127417, November 12, 2024. Background:Atherosclerotic cardiovascular disease (ACVD) is the leading cause of mortality in the U.S, and increasing age is one of the greatest risk factors for the development and prognosis of ACVD. However, ACVD-related mortality trends in older adults have not yet been established.Aims:This study aims to highlight the annual trends and demographic differences in ACVD-related mortality among older adults in the U.S. from 1999 to 2021.Methods:The CDC WONDER multiple-cause of death database was examined from 1999 to 2021 for ACVD-related mortality in adults >65 years of age. Age-adjusted mortality rates (AAMRs) per 100,000 persons was calculated. Trends and annual percent changes (APCs) were calculated, and subsequently stratified by overall, sex, race/ethnicity, urbanization status, and census region.Results:Between 1999 and 2021, 9,307,495 ACVD-related deaths occurred among older adults in the U.S. AAMRs decreased from 1370.7 in 1999 to 803.5 in 2014 (APC, -3.64 [-3.89 to -3.46]), after which it gradually decreased to 741.3 in 2019 (APC, -1.24 [-2.54 to 0.19]), and then increased to 841.5 in 2021 (APC, 7.00 [3.92 to 9.18]). Men had consistently higher AAMRs than women from 1999 (AAMR men: 1754.1 vs women: 1122.2) to 2021 (AAMR men: 1169.6 vs women: 599.6). Non-Hispanic (NH) Black or African American older adults had the highest AAMR in 2020 (886.1), followed by NH White (849.4), NH American Indian/Alaska Native (752.5), Hispanics or Latino (718.3) and NH Asian or Pacific Islanders (494.4). AAMR also varied substantially by region (overall AAMR until 2020: Midwest 875.1; South 872.2; Northeast 801.0; West 789.2), and rural areas had higher ACVD-related mortality (993.5) than urban regions (954.7).Figure 1.Conclusion:Following a progressive decrease until 2019, ACVD-related mortality in U.S. older adults demonstrated a sharp increase in mortality in 2020 and 2021. The highest AAMRs were observed among Black or African American adults and men, and among patients living in the Midwestern and non-metropolitan areas. A targeted approach, with tailored strategies is required to counter the recent surge in ACVD-related mortality in older adults in the U.S.

Circulation, Volume 150, Issue Suppl_1, Page A4145765-A4145765, November 12, 2024. Background:The incidence burden of maternal hypertensive disorders has increased by 30% globally. This study analyzed the trends in prevalence and death rates from maternal hypertensive disorders across various states in the United States from 1990 to 2021.Methods:Using the Global Burden of Disease (GBD) database, we compared the following levels, stratified by state, between the beginning of 1990 and the end of 2021: hypertensive disorders of pregnancy, percentage prevalence change, mortality percentage change by age-standardized rates per 100,000 population, and age-stratified changes in the rate of incidence and mortality. The analysis was conducted using Microsoft Excel (16.7).Results:The analysis revealed notable interstate variability in the prevalence and death rates of maternal hypertensive disorders (Figure 1). Nevada exhibited the highest increase in prevalence (0.87%), followed by Hawaii (0.65%) and Idaho (0.54%). In contrast, Mississippi experienced the largest decrease in prevalence (-0.22%), followed by Louisiana (-0.20%) and Maine (-0.19%). Regarding death rates, the District of Columbia saw the most significant decrease (-0.67%), followed by New York (-0.45%) and New Jersey (-0.42%). Conversely, West Virginia had the highest increase in death rates (0.89%), followed by Alaska (0.52%) and Kentucky (0.51%). The analysis of Age stratified subgroups in each state showed the maximum increase in mortality change in the age group of 40–44 years, followed by 35–39 years, with West Virginia having the highest percentage change mortality rates (2.55%; age group 40–44 years) and District of Colombia showing a sharp decrease in the percentage mortality rates (-0.72%; age group 30-34 years). Incidence percentage changes showed similar patterns, with Virginia showing a (3.41%; 40–44 years), closely followed by New York (3.31%; 40–44 years).Conclusion:The data reveal significant disparities in both the prevalence and death rates of maternal hypertensive disorders across different states. Additionally, an increase in mortality and incidence rate changes of hypertension in pregnancy was observed in higher age groups, particularly among women aged 35–39 and 40–44. These findings highlight the need for tailored, state-specific public health strategies to effectively address targeted interventions for older age groups and mitigate the impact of maternal hypertensive disorders.

Circulation, Volume 150, Issue Suppl_1, Page A4144731-A4144731, November 12, 2024. Introduction:In 2021, India reported an estimated 166,017 deaths related to Rheumatic Heart Disease (RHD). Since 2010, the Indian government has implemented various initiatives to reduce this burden. The Indian Council of Medical Research (ICMR) launched the “Jai Vigyan Mission Mode Project,” focusing on raising awareness, early detection, treatment, and infrastructure strengthening. The National Programme for Prevention&Control of Cancer, Diabetes, Cardiovascular Diseases&Stroke (NPCDCS) and Rashtriya Bal Swasthya Karyakram (RBSK) programs have established NCD clinics and cardiac care units, conducted health education campaigns, and trained medical staff for RHD prevention and control. Key initiatives include using RHD registers, regular penicillin prophylaxis, and promoting early diagnosis and treatment. The development of the low-cost Sree Chitra Valve has also increased treatment affordability. This study aims to evaluate the impact of these government efforts on reducing RHD-related mortality in India.Methods:Data from the Global Health Data Exchange (GHDx) for the 2021 Global Burden of Disease was analyzed to assess the global burden of RHD cases from India and the death rates per 100,000 population between 2010 and 2021 and predictive models adopted for estimates till 2030.Results:Between 2010 and 2014, the global mortality linked to RHD from India increased from 45.23% to 46.94%, then decreased gradually to 44.47% in 2021. Our predictive model estimates that India will contribute around 40.96% of global RHD deaths by 2030. Initially, the age-standardized RHD death rate per 100,000 population was lower among females than males, but it rose higher than males from 2013 onwards. A continuous reduction in the rate was observed in females from 2013 to 2021. Meanwhile, a declining trend was seen among males and combined (male + female) over the study period. By 2030, the overall death rate per 100,000 population is estimated to reach 9.23 (95% CI 7.24-11.22)(Figure 1).Conclusion:Our study confirms the downward trend of RHD mortality rates in India, likely linked to the multiple health initiatives. This highlights the need for sustained public health efforts to continue reducing RHD mortality.

Circulation, Volume 150, Issue Suppl_1, Page A4145182-A4145182, November 12, 2024. Background:Ischemic heart disease (IHD) continues to be a major contributor to global mortality. Metabolic risk factors are known to be the leading drivers of IHD burden. Our study aims to explain the trends in Metabolic Risk Factors (MRF) associated IHD mortality by utilizing Global Burden of Disease Study data spanning over three decades from 1990 to 2021.Method:MRF associated IHD mortality rates in the United States from 1990 to 2021 were sourced from the Global Burden of Diseases 2021 database. Monte Carlo permutation analysis utilizing JointPoint Regression Software (version 4.9.0.1, NCI) was employed to estimate the time trends, using annual percentage change (APC) and average annual percentage change (AAPC) metrics. Initially, these trends were assessed for the overall population. Analysis was then stratified by gender, evaluating age-adjusted rates separately for males and females. Further stratification involved, assessing age-specific trends within two distinct age groups: younger adults (20-54 years) and older adults ( >55 years).Results:A statistically significant decline in overall mortality was noted, with a moderate decline occurring during the decade 1990 to 2001 (APC= -2.2, p

Circulation, Volume 150, Issue Suppl_1, Page A4147580-A4147580, November 12, 2024. Background and Aims:Hypertension stands as the foremost preventable cause of premature mortality and is expected to have a global burden of up to 55%. Here we aim to examine the trends in age-standardized death rates (ASDR), years of life lost (YLL), and disability-adjusted life years (DALY) for alcoholic hypertension, pinpoint the vulnerable populations, and raise awareness about the global health burden of alcohol-related hypertension.Methods:Data on alcohol-related hypertension was extracted from the Global Burden of Diseases 2021 study, including ASDR, YLL, and DALY from 1990 to 2021. The dataset was globally divided and categorized by continents and World Bank income levels. Joinpoint regression was performed to determine annual percentage change (APC) and average annual percentage change (AAPC) from 1990 to 2021.Results:Globally, the age standardized death rates (ASDR) for alcohol-related hypertension had an overall decline from 1990-2021. In 1990, ASDR was 1.12 (95% UI 0.72-1.6) and it declined to 0.94 in 2021 (AAPC=-0.54; 95% CI -0.57 to -0.50). Although the overall trend is declining, some prominent spikes in mortality rate were observed, with the most prominent one seen from 2006-2010 (APC=1.38; 95% CI 1.04-1.82). Globally, the disability-adjusted life-years (DALYs) rate was 23.75 in 1990 and it decreased to 18.86 in 2021 (AAPC=-0.73; 95% CI -0.76 to -0.69). From 1990 to 2021, the age standardized years of life lost (YLL) showed a continuous drop with an AAPC of -0.78 (95% CI -0.81 to -0.75). In continent-wise analysis, North America and Europe had higher ASDRs while Asia and Africa had lower ASDRs. From 1990 to 2021, North America and Europe had AAPC of 0.44 (95% CI 0.36 to 0.53) and AAPC of 0.23 (95% CI 0.16 to 0.31) respectively. Conversely, the AAPCs for Africa and Asia showed significant decline and were -0.16 (95% CI -0.19 to -0.15) and -1.37 (95% CI -1.41 to -1.33) respectively. According to World Bank income levels, upper-middle income countries had declining death rates while lower-middle and lower-income countries had increasing death rates throughout.Conclusion:Alcohol-related hypertension remains a global health concern. While overall trends show a decline in mortality rates, spikes and variations across continents and income levels highlight the need for targeted interventions.

Circulation, Volume 150, Issue Suppl_1, Page A4148102-A4148102, November 12, 2024. Introduction:Ischemic stroke and renal failure frequently coexist, impairing patient outcomes. Comprehending this association is imperative in formulating a multidisciplinary methodology to augment patient outcomes and quality of life.Objective:We offer estimates showing the evolution of kidney dysfunction related ischemic stroke from 1990 to 2021. It will utilize disability-adjusted life years (DALYs), years of life lost (YLLs) and age-standardized death rates (ASDR) to find discrepancies overall survival outcomes in both sexes.Methods:Data on ASDR, DALY, and YLL were extracted from the GBD database. After examining global trends, we analyzed continents, socio-demographic index (SDI) and World Bank income level classification of countries. Using Joinpoint regression, the average annual percentage changes (AAPC) were determined.Results:The ASDR for kidney dysfunction related ischemic stroke showed a declining trend globally between 1990 and 2021. The ASDR was 7.29(95%UI: 4.68-10.07) in 1990 and dropped to 4.24 (AAPC: -1.73; 95% CI: -1.76 to -1.69) in 2021. DALYs dropped from 130.3(95%UI: 90.36-172.67) in 1990 to 82.1 (AAPC: -1.47; 95% CI: -1.50 to -1.44) in 2021. YLL had a consistent decline from 1980 to 2021, with an AAPC of -1.66 (95% CI: -1.69 to -1.62). High-middle and middle SDI region had higher death rates throughout the study period.Asia and America had lower ASDRs, whereas Europe and Africa had higher ASDRs across the board. Africa’s AAPC was -0.37 (95% CI: -0.4 to -0.32) between 1990 and 2021. Similarly, Europe’s AAPC of -2.85 (95% CI: -2.93 to -2.77) showed a decline from 1990 to 2021. Asia’s AAPC showed a drop, coming in at -1.19 (95% CI: -1.22 to -1.15). America’s AAPC was -1.97 (95% CI: -2.02 to -1.91).According to world bank income levels, upper-middle and lower-middle income countries had higher ASDRs.Conclusion:Due to similar risk factors and bidirectional effects, the combination of ischemic stroke and renal failure worsens patient outcomes. In order to effectively address the intricate interactions between various illnesses and enhance patient prognosis, an in-depth investigation of the reasons behind stark disparities in death rates is necessary.

Circulation, Volume 150, Issue Suppl_1, Page A4146785-A4146785, November 12, 2024. Background:Dementia is a prevalent comorbidity in patients undergoing the transcatheter edge-to-edge repair (TEER) procedure of the mitral valve. This study compares outcomes of mitral valve TEER in patients with and without dementia, utilizing data from the National Inpatient Sample (2016-2021)Methods:We conducted a retrospective cohort study on 48,085 patients without dementia and 3,125 with dementia undergoing mitral valve TEER. Multivariate logistic regression was employed to compare outcomes, adjusting for potential confounders. Primary outcomes included mortality and major complications, while secondary outcomes encompassed specific procedural complications.Results:Patients with dementia were older (mean age: 80.896 vs. 76.69 years, p-value

Circulation, Volume 150, Issue Suppl_1, Page A4146248-A4146248, November 12, 2024. Introduction:Lower Extremity Peripheral Arterial Disease (PAD) ranks as the leading cause of incidence among all cardiovascular diseases (CVD) in the United States. Due to a significant lack of data on the overall burden of PAD, this pioneering study investigates the trends of PAD over the past three decades in the US, including the initial two years of the COVID-19 pandemic.Method:We estimated prevalence, incidence, deaths, and disability-adjusted life years (DALYs) due to PAD by age, sex, year and location across the US from 1990-2021 using the global burden of disease 2021 methodology. Results were presented in absolute counts and age-standardized rate (per 100,000 person-years)Results:From 1990 to 2021, the overall prevalence of PAD in the US rose from 8.6 million (95% uncertainty interval: 7.4-10 million) to 14.9 million (13.4-16.6 million). The total percentage change (TPC) in deaths increased by 93% (82%-102%), and DALYs by 87% (79%-96%). Pennsylvania recorded the highest increase in age-standardized incidence rate (ASIR) at 3%, followed by Delaware at 2%. Kansas saw the highest death rate (ASMR) increase at 20%, with Kentucky close behind at 19%. The 65-69 age group had the highest incidence count at 265,188, while the 85-89 age group saw the most deaths at 1,827, and the 70-74 age group recorded the most DALYs at 36,772 in 2021. Males experienced a higher increase in TPC across incidence, deaths, and DALYs compared to females, with figures at 85% vs 56%, 104% vs 85%, and 99% vs 76%, respectively.Conclusion:While deaths due to Peripheral Arterial Disease (PAD) constituted only 1.22% of all cardiovascular-related fatalities in the US in 2021, the growing burden of the disease highlights a critical area for public health focus. Although mortality rates remain relatively low, the high incidence compared to other cardiovascular diseases suggests the need for targeted prevention and early intervention strategies. Strengthening awareness, improving diagnostics, and enhancing treatment accessibility can help mitigate the rising impact of PAD and improve cardiovascular health outcomes nationwide.

Circulation, Volume 150, Issue Suppl_1, Page A4128457-A4128457, November 12, 2024. Background:The U.S. population has seen a dramatic increase in the burden of hypertension (HTN) among younger adults. However, HTN-related mortality trends among younger adults have not been investigated.Aim:We examined the trends and demographic differences in HTN-related mortality among younger adults in the U.S.Methods:Data from the CDC WONDER database was examined from 1999 to 2021 for HTN-related mortality in adults between 15 to 45 years of age. The International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10) codes employed were as follows: I10-I15 (hypertensive diseases). Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent changes (APCs) with 95% confidence intervals (CIs) were calculated and stratified by year, sex, race/ethnicity, urbanization status and census region.Results:Between 1999 and 2021, 201,860 HTN-related mortalities occurred among younger adults in the U.S. The AAMR increased from 2.8 in 1999 to 5.0 in 2001 (APC, 35.3 [20.6 to 44.5]), after which it steadily increased to 9.4 in 2019 (APC 3.1, [2.7 to 3.5]), and sharply increased to 13.9 in 2021 (APC 22.3; 95% CI 15.1 to 26.4). Men had consistently higher AAMRs than women from 1999 (AAMR men: 3.6 vs women: 1.9) to 2021 (AAMR men: 18.9 vs women: 8.8). Non-Hispanic (NH) Black or African American young adults had the highest AAMR in 2020 (30.2), followed by NH American Indian/Alaska Natives (29.6), NH White (9.9), Hispanics or Latino (9.3) and NH Asian or Pacific Islanders (5.0). AAMR also varied substantially by region (overall AAMR: South 9.3; Midwest 6.4; West 5.8; Northeast 5.4), and rural areas had higher HTN-related mortality (8.5) than their urban counterparts (7.0).Figure 1.Conclusion:Following a steady increase until 2019, HTN-related mortality increased among young adults between 2020 and 2021. The highest AAMRs were observed among men and Black or African American young adults, and people residing in the Southern and non-metropolitan areas. This emphasizes the necessity of tailored interventions to mitigate the burden and reduce the current disparities in HTN-related mortality among young adults in the U.S.

Circulation, Volume 150, Issue Suppl_1, Page A4147113-A4147113, November 12, 2024. Background:Transcatheter Aortic Valve Implantation (TAVI) is a rapidly evolving procedure with significant implications for patient outcomes. Understanding trends in TAVI outcomes over time can help identify areas for improvement and guide clinical practice. This study aims to analyze trends in mortality, procedural complications, length of stay (LOS), and total charges for TAVI patients from 2016 to 2021.Methods:We performed a trend analysis of TAVI procedures using data from the National Inpatient Sample (NIS) from 2016 to 2021. Outcomes assessed included in-hospital mortality, transfusion rates, permanent pacemaker (PPM) insertion, postprocedure shock, prosthetic valve dysfunction, intraprocedure stroke, LOS, and total hospital charges. The P-trend test was used to determine statistical significance over the six-year period.Results:A total of TAVI procedures were analyzed from 2016 to 2021. In-hospital mortality decreased significantly from 1.76% in 2016 to 1.06% in 2021 (P-trend

Circulation, Volume 150, Issue Suppl_1, Page A4138426-A4138426, November 12, 2024. Background:Geographic inequities in cardiovascular mortality are pervasive in the US. Pandemic-related delays in screening and treatment, economic loss, and worsening social determinants may have widened geographic disparities in cardiometabolic health, particularly in states that were hardest hit by these spillover effects. Understanding changes in state-based inequities could inform targeted public health efforts to advance cardiovascular health.Questions:Did the prevalence of cardiometabolic risk factors (diabetes, hypertension, hyperlipidemia, obesity) and lifestyle factors (alcohol consumption, physical inactivity, tobacco use) change between 2011 and 2021? How did between-state differences change over this period?Methods:We included adults from the CDC’s Behavioral Risk Factor Surveillance System. Survey-weighted logistic regressions models were used to calculate age and sex-adjusted risk difference between states with the highest and lowest adjusted prevalence rates of each risk factor in 2011 and 2011, respectively. An interaction term for state and year was included to assess for differential changes in between-state disparities.Results:From 2011 to 2021, there were increases in the age- and sex-adjusted prevalence of diabetes (10.9% [95% CI, 10.7,11.0] to 12.4% [12.2,12.6]), hypertension (32.4% [32.1,32.7] to 33.7% [33.4,34.0]), and obesity (27.5% [27.2,27.7] to 33.1% [32.8,33.5]). Geographic inequities widened, with increases in the difference between states with the highest vs lowest prevalence of diabetes (5.7% [5.3,6.1] to 7.8% [7.3,8.3]), hypertension (14.2% [13.6,14.8] to 17.2% [16.4,17.9]) and obesity (14.3% [13.6,15.0] to (15.7% [14.7,16.7])(Table).The prevalence of alcohol consumption (18.0% [17.7,18.2] to 15.6% [15.3,15.8]), physical inactivity (25.7% [25.4,27.4] to 24.0% [23.6,23.7]), and tobacco use (44.9% [44.5,45.3] to 36.3% [35.8,36.8]) decreased, and between-state differences did not widen.Conclusion:In this national study, the prevalence of hypertension, obesity, and diabetes increased from 2011 to 2021, and state-based inequities widened. Our findings highlight the urgent need for public health interventions to address widening state-based disparities in cardiometabolic health.

Circulation, Volume 150, Issue Suppl_1, Page A4138225-A4138225, November 12, 2024. Background:Timely transfer for PCI is paramount in the management of STEMI. This has been shown to reduce myocardial damage, optimize reperfusion therapy and mitigate the post procedural complications associated with PCI. This study’s aim was to describe the in-hospital outcomes associated with acute inter-hospital transfer of patients with STEMI for PCI in comparison with patients directly admitted to a primary PCI center.Methods:The National Inpatient Sample (NIS) was used to identify patients who underwent PCI for STEMI between the years 2016-2021. Based on several transfer indicators, primarily admitted patients and patients with acute inter-hospital transfer were identified. Logistic and linear regression models were used to analyze the primary outcome of in-hospital mortality and secondary outcomes of length of hospital stay, hospital charge, and occurrences of post-procedure complications.Results:Observations were weighted to obtain a national estimate of 748,430 patients with known transfer status who underwent PCI for STEMI. Of these, 625,520 patients were primarily admitted at PCI centers and 122, 910 patients were transferred from non-PCI centers. The mean age of patients with STEMI undergoing PCI was 62 years, and 72 % of the patients were male. There was no significant difference in mortality between patients transferred and patients primarily admitted for PCI due to STEMI. However, patients transferred had longer hospital stay and significantly higher healthcare cost, with a mean difference of 0.72 days (95% CI: 0.65 – 0.81 days, p-value

Circulation, Volume 150, Issue Suppl_1, Page A4146890-A4146890, November 12, 2024. Background:COVID-19 has introduced new complexities in the management of patients undergoing the transcatheter edge-to-edge repair (TEER) procedure of the mitral valve. This study compares outcomes of mitral valve TEER in patients with and without COVID-19, utilizing data from the National Inpatient Sample (2020-2021).Methods:We conducted a retrospective cohort study on 23,465 patients without COVID-19 and 85 patients with COVID-19 undergoing mitral valve TEER. Multivariate logistic regression was employed to compare outcomes, adjusting for potential confounders. Primary outcomes included mortality and major complications, while secondary outcomes encompassed specific procedural complications.Results:Patients with COVID-19 were younger (mean age: 73.176 vs. 76.178 years, p-value

Circulation, Volume 150, Issue Suppl_1, Page A4120332-A4120332, November 12, 2024. Introduction:Sleep apnea (SA) is often underrecognized and undertreated despite its high prevalence in the adult population and its association with adverse cardiovascular outcomes. There are limited estimates of national trends on cardiovascular mortality in older patients with sleep apnea. We aimed to assess the sex and race-related trends of ischemic heart disease (IHD) mortality in the older adults with SA using a large population-based database.Methods:We utilized the Centers for Disease Control and Prevention Wide-Ranging, Online Data for Epidemiologic Research (CDC WONDER) database which provides information from death certificates of all US residents according to the International Classification of Diseases, Tenth Revision (ICD-10). The demographic and mortality data were obtained for the United States population >65 years from 1999 to 2021. Ischemic heart disease (ICD-10 codes I20-I25) was listed as the underlying cause of death, and SA (G47.3) as a contributing cause of death. Age adjusted mortality rates (AAMRs) per 1,000,000 population were calculated by standardizing deaths to the year 2000 US population. We used Jointpoint Regression Program to analyze temporal trends in mortality from 2000 to 2021. Average annual percentage change (AAPC) with 95% CI were calculated to examine trends in AAMR over time.Results:Overall, AAMR of IHD mortality for patients with SA increased from 7.9 per 1,000,000 (95% CI, 6.9-8.8) in 1999 to 53.4 per 1,000,000 (95% CI, 51.4-55.4) in 2021 with an AAPC of 9.1% per year (95% CI, 8.8-9.5). Men had consistently higher AAMR than women throughout the study period (overall AAMR men: 45.51 (95% CI, 44.8-46.2); women: 12.5 (95% CI, 12.2-12.8). Both the groups had a similar increasing trend in AAMR, with men having a steeper increase. [AAPC men: 9.3% (95% CI, 8.5-10.8) versus AAPC women: 8.6%, 95% CI, 8.1-9.7]. Non Hispanic (NH) White population had the greatest AAMR throughout the study period, followed by NH Black and Hispanic or Latino. The NH White population had the largest increase in AAMR from 1999 to 2021 (AAPC 9.4%, 95% CI:8.9-10.1).Conclusion:In the United States, there has been a general increase in IHD mortality related to sleep apnea over the last two decades. This rising trend as noted in our analysis is concerning and underscores the need for more robust cardiovascular surveillance in these patients.

Circulation, Volume 150, Issue Suppl_1, Page A4146702-A4146702, November 12, 2024. Background:Aortic aneurysm, a potentially life-threatening condition characterized by weakness of the aortic wall, poses a significant health risk, especially when concurrent with high systolic blood pressure. In an aging population experiencing the effects of smoking and atherosclerotic disease, it is imperative to explore the burden associated with hypertension-related aortic aneurysm mortality.Methods:The Global Burden of Diseases (GBD) study was used to extract data for high systolic blood pressure-related aortic aneurysm from 1990-2021. Dataset was stratified globally, continent wise, and by World Bank income levels. Age-standardized death rates (ASDRs), disability-adjusted life years (DALYs), and years of life lost (YLL) were examined. Jointpoint regression was used to quantify these estimates and calculate average annual percentage changes (AAPCs).Results:Globally, the age standardized death rates (ASDR) for hypertension-related aortic aneurysm rupture had a declining trend from 1990-2021. In 1990, the ASDR was 0.52 (95% UI 0.39-0.65), which declined to 0.32 in 2021 (AAPC=-1.53; 95% CI -1.57 to -1.48). The disability-adjusted life-years (DALYs) were 9.55 in 1990 and decreased to 6.19 in 2021 (AAPC=-1.38; 95% CI -1.42 to -1.33). The age standardized years of life lost (YLL) also showed a uniform drop over the same period (AAPC=-1.38; 95% CI -1.42 to -1.33). In continent wise analysis, North America and Europe exhibited significant decline [(AAPC=-2.44; 95% CI -2.48 to -2.40) and (AAPC=-1.58; 95% CI -1.64 to -1.51) respectively], while Africa showed minimal variation. Importantly, however, Asia was the only continent with a rising mortality during this period (AAPC=0.77; 95% CI 0.73-0.81). According to World Bank income levels, high income countries had continuous decline in death rates while lower-middle income countries had increasing deaths rates. Upper-middle and low-income countries both had minimal variation in death rates during this period.Conclusion:Global efforts to reduce hypertension-related aortic aneurysm mortality have yielded positive results, but regional disparities persist. Continued research, prevention, and healthcare interventions are crucial to further mitigate this health risk.

Circulation, Volume 150, Issue Suppl_1, Page A4146129-A4146129, November 12, 2024. Introduction:Cardiovascular Disease (CVD) is the primary cause of death and disability among women worldwide. Despite its escalating impact, there remains a significant gap in consistent and comparative global data on the burden of CVD in women. This groundbreaking study provides the first estimates of the CVD burden in women over the past three decades, including the first two years of the COVID-19 pandemic.Method:Using the Global Burden of Disease 2021 framework, we estimated the prevalence, incidence, deaths, disability-adjusted life years (DALYs), and years lived with disability (YLDs) due to cardiovascular disease (CVD) in women. This analysis spans ages, years, and locations across 204 countries and territories from 1990 to 2021.Results:From 1990 to 2021, the total percentage change (TPC) in prevalence of the condition increased by 108%, followed by a 91% increase in incidence, and a 47% increase in deaths. Regionally, the highest TPC in age-standardized incidence rate (ASIR) was observed in Central Asia at 14%, while the highest mortality rate (ASMR) was in Southern Sub-Saharan Africa at 15%, and the highest YLD rate (ASYLDR) was in Australasia at 8% from 1990 to 2021. Nationally, Uzbekistan saw the largest increase in ASIR at 69%, and the United Arab Emirates had the highest increase in ASMR at 82%. In terms of socio-demographic index, the highest ASYLDR was observed in middle SDI regions with a 1% increase, while other regions saw decreases. Regarding age, individuals aged 55 and over recorded the highest deaths at 8.4 million, followed by the 20-54 age group with 659,296, and under 20s at 37,034 in 2021. Ischemic heart disease constituted 43.46% of all CVD-related deaths in 2021.Conclusion:Deaths due to cardiovascular disease (CVD) in women attributable to metabolic risk factors accounted for 70.75% of all CVD-related fatalities. This was followed by behavioral risk factors at 34.64% and environmental risk factors at 31.62%. The disproportionate impact of metabolic, behavioral, and environmental risk factors on cardiovascular disease-related deaths in women highlights the critical need for targeted intervention strategies. Addressing these risk factors through comprehensive public health initiatives could significantly reduce the global burden of CVD in women.