Abstract: FR-PO372
Trends in Cardiovascular Mortality among Patients with CKD
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Dweik, Loai, Cleveland Clinic Akron General, Akron, Ohio, United States
- Daoud, Ansaam, University Hospitals, Cleveland, Ohio, United States
- Tanphaichitr, Natthavat, Cleveland Clinic Akron General, Akron, Ohio, United States
Background
Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD). Impaired kidney function accelerates CVD due to factors like hypertension, fluid overload, dyslipidemia, and disturbances in mineral metabolism. Studies investigating trends in cardiovascular mortality among patients with CKD are lacking. We aim to observe the trends in proportionate cardiovascular mortality (PCM) in the last two decades in U.S.
Methods
This retrospective cohort study analyzed data from the Multiple Cause of Death files maintained by the National Center for Health Statistics. The dataset includes death certificates for U.S. residents, specifying the one primary cause of death as determined by the treating physician, up to twenty contributory causes, and demographic details. We explored the trend in PCM, which is the ratio of cardiovascular deaths (primary cause of death coded as I00-I99 in the International Classification of Diseases, version 10 [ICD-10]) to total deaths, in patients diagnosed with CKD (identified by ICD-10 code N18) from 1999 to 2020. We used Pearson’s correlation coefficient for trend analysis and the Chi-square test for comparative assessments.
Results
1,938,505 deaths occurred in patients with CKD over the study period, with an age adjusted mortality rate of 26.3 per 100,000 people. Overall, 605,384 died of CVD causes (31%). The mean age of CVD mortality was 78 years. PCM decreased from 39% to 24% from 1999 to 2020 (r -0.9326, p<0.0001). PCM was higher in men (32% vs 30%, p<0.0001). Asian or Pacific Islanders exhibited the highest proportionate cardiovascular mortality at 33%, followed by Whites at 32%, African Americans at 28%, and American Indians or Alaska Natives at 24% (p 0.00). The most common cause of cardiovascular deaths was ischemic heart disease at 59%, hypertension 10%, cardiomyopathy 5%, valvular disease 4%, arrhythmia 4% and 20% other causes.
Conclusion
In conclusion, the past two decades have witnessed a significant decline in the proportion of deaths attributed to CVD causes among patients with CKD. Our analysis suggests improved management strategies and potentially highlights the effectiveness of preventative measures in CKD. Further research is needed to elucidate the specific factors contributing to this positive shift in this high-risk population.