In US adults aged 65 and older with renal failure and hypertension, age-adjusted cardiovascular mortality rates experienced a dramatic decline of 47.2% per year from 2012 to 2015.
Observational
In older US adults with renal failure and hypertension, cardiovascular mortality experienced a dramatic and unexplained 47% annual decline between 2012 and 2015, followed by a partial rebound.
Estimación del efecto: APC -47.2%
valor p: p=<0.01
Background: Cardiovascular disease is a leading cause of death in older adults who have both renal failureand hypertensive disease. However, national trends describing mortality in this high-risk population remainunclear. Hypothesis: We hypothesized that cardiovascular mortality in older adults with renal failure and hypertensivedisease experienced significant changes from 1999 to 2020, with variations by sex, race, region, and urbanization status. Methods: We used public-use mortality data from the Centers for Disease Control and Prevention for decedents 65 years with renal failure and hypertensive disease listed as contributing conditions and cardiovascular disease as the underlying cause of death. Annual percentage changes (APCs) in age-adjusted mortality rates were estimated using joinpoint regression. Statistical significance was set at P 0.05. Results: From 1999 to 2012, the overall mortality rate rose modestly (APC ~+2.1; P = 0.12), followed by a sharp decline from 2012 to 2015 (APC ~47; P 0.01). A subsequent increase from 2015 to 2020 (APC ~+13; P = 0.09) was not statistically significant. Analyses by sex showed similar patterns, with males and females both exhibiting substantial downturns between 2012 and 2015. Race and ethnicity subgroups likewise demonstrated steep drops (APC ~43% to 53%) during 2012-2015, followed by partial rebounds. Regionally, the West had a small but significant rise from 1999 to 2012 (APC ~+3.6; P = 0.01) before a pronounced decline (APC ~48; P = 0.001). Both metropolitan and non-metropolitan areas reflected the overall trend, with mild increases until 2012, then marked reductions, and modest upticks thereafter. Conclusions: In older adults with renal failure and hypertensive disease, cardiovascular mortality underwenta modest increase through 2012, a dramatic dip from 2012 to 2015, and a partial rebound afterward. Thesepatterns underscore the importance of ongoing surveillance and targeted prevention strategies to reducecardiovascular burden in this susceptible population.
Bhimani et al. (Thu,) conducted a observational in Cardiovascular disease with renal failure and hypertension. In US adults aged 65 and older with renal failure and hypertension, age-adjusted cardiovascular mortality rates experienced a dramatic decline of 47.2% per year from 2012 to 2015.