Abstract Body (Do not enter title and authors here): Abstract
Background: Cerebrovascular disease (CVD) mortality is considerably influenced by disorders of lipoprotein metabolism (LMD). While hypercholesterolemia is a recognised risk factor for coronary heart disease, there is, now, a greater appreciation of its connection to cerebrovascular disease outcomes, especially ischemic stroke. Little, however, is published about the trends and the differences in those trends for LMD-associated CVD mortality at a nation-wide population level.
Methods: From 1999 to 2023, mortality statistics from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database were used for this descriptive study. Wherever LMD (ICD-10: E78.0–E78.9) and CVD (ICD-10: I60–I69) were identified as either underlying or contributory cause for death among adults aged ≥25 years were included. The United States (U.S.) population in year 2000 was used to standardize the age-adjusted mortality rates (AAMRs) per 1,000,000. Joinpoint regression analysis was utilized to stratify results by sex, race/ethnicity, census regions and urban-rural classification, to estimate annual percent change (APC) with 95% confidence intervals.
Results: Between 1999 to 2004 (APC 14.83*) and 2018 to 2021 (APC 16.52*), there were especially notable upswings in the total AAMR for LMD-associated CVD, which notably increased from 14.42 in 1999 to 80.01 in 2023. AAMRs were also consistently higher for males. Among races, the greatest mortality rates were recorded for non-Hispanic (NH) Black people (50.16) and NH White people (42.58). Regional data revealed that the West and South experienced the most notable recent increases in AAMRs. Moreover, the rural areas had higher AAMRs than metropolitan regions. These differences reflect the effects of long-standing inequities that are rooted in lifestyle risk factors, socioeconomic determinants of health and even access to healthcare.
Conclusion: Over the last 20 years, the death rate from LMD-associated CVD has exploded, with considerable socioeconomic, demographic and regional differences. These results are a cause for concern and underline the need for policy changes and focus on targeted public health initiatives. Furthermore, future initiatives ought to focus on the incorporation of more detailed statistics and make use of newly discovered and readily available biomarkers.