Disparities in mortality rates from aortic aneurysm and dissection by country-level income status and sex

Abstract

ObjectiveThe aim of this study was to investigate the impact of national income level and sex on mortality trends from aortic aneurysm and dissection, and all aortic disease as a whole. MethodsWe conducted an analysis of mortality trends from aortic disease between 2000 and 2019, utilizing data from the WHO mortality database. Countries were categorized into middle-income and high-income countries (MICs and HICs) based on income level. Age-standardized and sex-specific age-standardized mortality rates per 100,000 persons, along with male-to-female mortality ratios, were calculated. Trends over the study period were analyzed using joinpoint regression. ResultsOur analysis comprised 29 MICs and 46 HICs, with an average population of 595 million and 1,042 million during the observation period. During the observation period, age-standardized mortality rates from aortic disease decreased to 2.21 (2.17, 2.25) and 2.28 (2.26, 2.30) in MICs and HICs, respectively (average annual percentage change [APC] of -0.5% in MICs and -1.8% in HICs, p<0.05 for both). However, mortality rates from aortic dissection increased in HICs from 2000 to 2019 (average APC of 1.3%, p<0.001). Mortality from aortic disease, aortic dissection, and aortic aneurysm were male dominant in MICs and HICs, but decreasing trends during the observation periods except for aortic dissection in MICs. ConclusionsWe present the contemporary and comprehensive analysis of global socioeconomic status and aortic diseases mortality. While trends of mortality from aortic diseases are on the decline in both MICs and HICs, there is a striking increase in mortality for aortic dissection, specifically in HICs.