Abstract 4370795: Demographic and Regional Trends in Cardiovascular Disease Mortality Among Individuals with AIDS in the United States: A Retrospective 22-Year Analysis

Background: Cardiovascular disease (CVD) is a significant risk factor among individuals with acquired immunodeficiency syndrome (AIDS), influenced by factors such as HIV-related inflammation and anti-retroviral therapy side effects. Research Question: What are the demographic and regional trends and disparities for CVD-related mortality in AIDS patients in the US? Methods: We used the CDC WONDER mortality database to extract mortality data for CVDs (I00–I99) and AIDS (B20–B24) from 1999 to 2020 as age-adjusted mortality rates (AAMRs) per 1,000,000 US adults (≥25 years). AAMRs were analyzed using Joinpoint analysis to calculate the average annual percentage change (AAPC). Results: CVDs caused 60,545 deaths among US adults with AIDS, with an AAMR of 13.24 (13.14–13.35) and an AAPC of -3.39% (-4.59 to -1.85), indicating a downward trend. Males exhibited thrice the AAMR [19.97 (19.78–20.16)] than females [6.97 (6.86–7.08)]. Both sexes showed similar declines in AAMR [AAPC: -3.24% (-4.46 to -1.79) vs. -3.62% (-4.86 to -1.92)]. Younger adults had a greater AAMR [14.06 (13.94–14.18)] than older adults [9.89 (9.69–10.09)], but older adults showed an increase in AAMRs with an AAPC of 6.37% (5.25–8.07), while younger adults showed a decrease of -4.59% (-5.78 to -3.2). Among racial and ethnic groups, non-Hispanic (NH) Blacks had the highest AAMR [62.59 (61.91–63.28)], followed by Hispanics or Latinos [15.15 (14.8–15.49)], and NH Whites [5.54 (5.46–5.62)]. Hispanics showed the highest decline in AAMR [-4.66% (-5.96 to -3.22)], while NH Whites showed the lowest [-1.51% (-2.37 to -0.28)]. Regionally, the Northeast showed the highest AAMR [20.26 (19.95–20.57)], followed by the South [15.99 (15.79–16.18)], the West [11.01 (10.81–11.22)], and the Midwest [4.93 (4.8–5.07)]. The Midwest saw a slight non-significant incline in mortality with an AAPC of 0.92% (-0.24 to 2.22), while the Northeast had the highest decline of -6.96% (-8.53 to -5.48), followed by -2.34% (-3.37 to -1.07) in the West, and -1.88% (-2.94 to -0.2) in the South. Metropolitan areas had a greater AAMR [14.57 (14.45–14.69)] than non-metropolitan areas [6 (5.82–6.19)], with a decline of -3.66% (-4.92 to -2.05); while non-metropolitan areas showed an increase of 0.38% (-0.65 to 2.09). Conclusion: Overall, CVD mortality among US adults with AIDS declined significantly, with higher mortality rates in males, NH Blacks, and the Northeast, underscoring the need for targeted interventions in vulnerable populations.