Abstract 17068: Proportionate Suicide Mortality in Cardiovascular Disease in the United States From 1999 to 2019

Abstract

Introduction: Few studies have investigated disease associated suicide other than mental health. We aimed to assess suicide mortality in cardiovascular disease. Methods: We used CDC WONDER to access National Vital Statistics System data from 1999 to 2019. Suicide and CVD related deaths in patients ≥ 25 years of age were identified from multiple causes of death. Proportionate suicide mortality (PSM) was calculated as number of suicide deaths listed with CVD, divided by number of all cardiovascular-related deaths irrespective of suicide, and reported as PSM per 100,000 cardiovascular deaths. Joinpoint regression was used to examine changes in trend using annual percentage change (APC) overall and by sex, race/ethnicity, disease subtype, and age. Results: PSM by disease category from most to least were mental health,, nervous system, musculoskeletal, gastrointestinal, cardiovascular, respiratory, and lastly malignant neoplasm. The CVD PSM increased from 62.8 in 1999 to 90.5 in 2019 (average APC 2.1* [95% CI, 0.2 to 3.9]). Notably, APC decreased from 2013-2019 (APC -2.1 (95% CI -3.6 to -0.5). In racial/ethnic groups, PSM was highest in non-Hispanic White (NHWs) (103.8) then Hispanic/Latino (H/L) (63.6), and lastly NH Black (NHB) (29.2) individuals. PSM was highest in 25-39 years age group (858) followed by 40-54 years (382.8), 55-69 years (146.2), 70-84 years (55.9), and lastly 85+ (17). APC in PSM initially increased in men (3.1 until 2013), women (4.1 until 2014), NHW (3.9 until 2013), H/L (3.5 until 2014), 40-54 (2.9 until 2013), 55-69 (6.0 until 2013) then either stabilized or decreased. While APC in NHBs (1.0) and 25-39 years (1.4) consistently increased till 2019. Conclusion: Among non-mutually exclusive disease categories, CVD ranked 3rd to last. PSM in CVD peaked in the early 2010s, with variable increases across various sex, racial/ethnic, and age groups. Further research is needed to understand the causes of these disparities to develop preventative strategies.