Gender, Racial, and Regional Disparities in Non-Rheumatic Aortic Valve Disease-related Mortality Trends in older U.S. Adults from 1999-2020

Abstract

Objectives: Background: The aging U.S. population has led to a rise in Non-Rheumatic Aortic Valvular Diseases (NRAVD), yet data on NRAVD-related mortality trends among adults ≥55 years remain limited. Methodology: Death certificates from the CDC WONDER database (1999–2020) were analyzed for NRAVD-related mortality in adults ≥55 years. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated by year, sex, race/ethnicity, and urbanization status. Results: Between 1999 and 2020, 658,148 NRAVD-related deaths occurred in adults ≥55 years (54.5% females, 45.5% males). The overall AAMR declined from 44 in 1999 to 40 in 2020. Males consistently had higher AAMRs than females. NH White adults had the highest AAMR (45.6), while NH Asian/Pacific Islanders had the lowest (18.5). Mortality rates were higher in rural areas (44.5) compared to urban counties (40.9), with an increasing trend in rural populations. Geographically, Minnesota had the highest AAMRs (~9), while Georgia and Louisiana had the lowest (~3.4). The South had the highest proportion of NRAVD deaths (29.5%), while the Northeast had the lowest (20.9%). Conclusion: Despite an overall decline in NRAVD-related mortality, rural areas exhibited an upward trend, with White and rural male populations at the highest risk. Targeted health policies for early screening and timely interventions are crucial to reducing NRAVD-related mortality and addressing healthcare disparities.