Abstract 4145963: Mortality Trends of Pulmonary Hypertension and Congestive Heart Failure in the United States: A CDC WONDER Analysis

Introduction: Pulmonary hypertension (PH) is a common comorbidity in congestive heart failure (CHF) patients. Despite studies showing the negative impact of PH on outcomes in CHF, temporal analyses of combined mortality trends are unknown. Methods: We queried the CDC WONDER database for PH (ICD-10: I27.0, I27.2, I27.8, I27.9) and CHF (ICD-10: 50.0, 50.1, 50.9) related deaths in ≥ 45-year-olds. Joinpoint regression analysis assessed annual percentage change (APC) trends for underlying and contributing causes of death. Age-adjusted mortality rates (AAMR) were computed and compared cumulatively across subpopulation demographics. Results: From 2012 to 2016, significant temporal changes were noted in PH and CHF as underlying causes (APC: 4.50% [95% CI: 2.50, 6.36]). Conversely, PH and CHF as contributing causes showed notable shifts from 1999 to 2012 (APC: -2.38% [95% CI: -2.72, -2.11]) and 2012 to 2020 (APC: 2.24% [95% CI: 1.65, 3.04]). Gender-specific analysis revealed higher AAMRs among males (313.7) than females (240.3) across this period. Race-specific analysis indicated higher AAMRs among Blacks than Whites and Asians (285.1, 273.8, and 122.6, respectively). Variation across major regions was statistically significant with the Midwest having the highest AAMR (296.3). Conclusion: PH and CHF are major contributors to mortality, with trends showing limited improvement across gender, race, and region. While PH and CHF were increasingly recognized as primary causes of death, their role as contributing factors in mortality is even more significant and has been rising more sharply. Targeted public health interventions are needed to address these disparities.