Abstract
Background: Cardiovascular disease (CVD) and osteoporosis share common risk factors and often co-exist. In this study, we quantify CVD-related mortality trends in individuals with osteoporosis. Hypothesis: Among gender, racial, and geographic subgroups, disproportionate mortality rates related to CVD and osteoporosis are observed. Methods: We performed cross-sectional analyses using the CDC Wide-Ranging Online Data for Epidemiologic Research database to identify mortality rates from 1999 to 2020 with CVD as the underlying cause of death and osteoporosis within the multiple causes of death. Quantified measures included age-adjusted mortality rate (AAMR), average annual percentage change (AAPC), and 95% confidence intervals. Joinpoint regression (National Cancer Institute) was used for AAPC calculation. Stata (StataCorp LLC) was used for data visualization. Results: There was a total of 70,930 deaths from 1999 to 2020. The AAMR decreased from 1.76 in 1999 to 0.40 in 2020 [p <0.05] with an AAPC of -6.8%. There were a higher AAMR among females (1.34) compared to males (0.27) [p <0.05], with a similar AAPC (-6.6% and -7.2%, respectively [p >0.05]). White populations had the highest AAMR, followed by Asian populations (0.63), then Black populations (0.28) [p <0.05]. AAPC was similar among the three racial subgroups (-6.9%, -6.8%, -4.7%, respectively [p >0.05]). Non-Hispanic (0.98) subgroups had higher AAMR than Hispanic subgroups (0.45) [p <0.05], with a similar AAPC (-6.8% and -6.6%, respectively [p >0.05]). Non-metro regions (1.17) had higher AAMR compared to metro regions (0.9) [p <0.05], with a similar AAPC (-5.8% and -7.2%, respectively [p >0.05]). The Midwest (1.19) had the highest AAMR, followed by the West (1.13), South (0.80), and the Northeast (0.74) [p <0.05]. AAPC was similar among all US regions (-6.4%, -6.6%, -8.3%, and -6.4%, respectively [p >0.05]). Conclusion: Disparities related to CVD and osteoporosis related mortality exist among gender, racial, and geographic subgroups within the United States.
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