Abstract 4367886: Trends in Mortality from Valvular Heart Disease and Chronic Kidney Disease in the United States, 1999–2020: CDC WONDER analysis

Introduction Valvular heart disease and chronic kidney disease are significant causes of mortality in the U.S. Their evolving trends remain underexplored in recent decades. We aim to analyze the mortality trends of valvular heart disease and chronic kidney disease from 1999-2020. Research Question: What are the temporal trends in mortality from valvular heart disease and chronic kidney disease in the United States from 1999 to 2020 across demographic and geographic subgroups? Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research) database were examined from 1999 to 2020. Crude mortality rate (CMR) and age adjusted mortality rate (AAMR) per 1,000,000 were calculated and stratified by sex, race/ethnicity, age groups, regions, and states. Temporal trends were described by calculating annual percent change (APC) and average APC (AAPC) in the rates using Joinpoint regression analysis Results: From 1999-2020, a total of 50319 deaths related to valvular diseases and chronic kidney disease among adults aged 25+. An overall increasing mortality trend was observed from 7.13 in 1999 to 13.57 in 2020 (AAPC: 3.33; 95% CI: 2.11 to 4.77; p <0.000001). Males had a higher overall AAMR (14.38) than females (8.17). Highest AAMR was observed in NH Black/African American (11.98), followed by NH American Indians (10.98), NH White (10.54), Hispanics/Latinos (7.83), and NH Asians (7.78). Among regions, highest mortality rate was found in West (12.25), followed by Midwest (11.57), Northeast (10.63), and South (8.78). States in the top 90 th percentile were Oregon (20.07), followed by Vermont (19.26), Washington (19.18), Minnesota (18.21), and Wisconsin (15.07). Rural had a higher AAMR (11.12) than urban (10.42). Highest number of deaths took place in Medical Facility- inpatient (49.64%). Highest CMR was observed in 85+ years. Conclusion There has been a significant increase in mortality associated with both valvular heart disease and chronic kidney disease. These trends highlight the urgent need for ongoing surveillance and targeted public health strategies to reduce the burden of these chronic cardiovascular and renal conditions.