Abdominal aortic aneurysms (AAAs) are a significant vascular pathology in older adults, often asymptomatic but with high mortality upon rupture. Despite advancements in diagnostic imaging and surgical interventions, AAAs remain a public health concern. This research letter analyzed CDC WONDER data on AAA-related deaths (ICD-10 I71.3 and I71.4) among US adults aged 65+ from 1999 to 2020. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, gender, age group, race/ethnicity, geography, and urbanization status. Between 1999 and 2020, there were 180,037 reported deaths in older adults due to AAA. The overall AAMR decreased from 32.6 to 13.2 per 100,000, with a significant decline from 2014 to 2020 (APC: −1.66; 95% CI: −2.48 to −0.48). Older men had a significantly higher AAMR than older women (31.2 vs. 12). Among racial and ethnic groups, Non-Hispanic (NH) Whites had the highest AAMR at 21.7, followed by NH American Indian or Alaska Native (14.5), NH Black (12.6), NH Asian or Pacific Islander (10.1), and Hispanic populations (8.4). Additionally, non-metropolitan areas exhibited higher AAMRs compared to metropolitan areas (23.9 vs. 18.7). While mortality rates have declined, disparities remain, with higher rates among older men, NH Whites, and non-metropolitan residents, highlighting the need for targeted and equitable interventions. Export

Emphysema, a significant global health issue, involves abnormal lung enlargement and wall destruction, affecting 9% to 12% of people worldwide. In the United States (US), 2 million people live with emphysema, with numbers expected to rise. Data on mortality trends and disparities associated with demographic factors is limited, underscoring our study’s focus on analyzing these patterns in US adults. This study examined death certificates from the CDC WONDER database for individuals aged 25 and older who died with emphysema (J43) between 1999 and 2020. Age-adjusted mortality rates (AAMRs) and annual percent change were calculated by year, gender, age group, race/ethnicity, geographic region, and urbanization status. Between 1999 and 2020, there were 484,095 reported deaths among emphysema patients. The overall AAMR decreased from 18.5 to 7.2 per 100,000 population, with an annual decrease of 8% from 2008 to 2015, followed by a slight recent increase. Analyzing by age groups, older adults had the highest AAMR of 42. Men had significantly higher AAMRs than women (13.4 vs 7.8). By race, non-Hispanic (NH) White patients had the highest AAMRs (11.3), followed by NH American Indian or Alaska Native (8.2), NH Black (7.7), Hispanic (3.9), and NH Asian or Pacific Islander patients (3.1). Nonmetropolitan areas had higher AAMRs compared to metropolitan areas (11.7 vs 9.8). Emphysema mortality has decreased overall but recently increased slightly. Higher rates are seen among older adults, men, NH White patients, and nonmetropolitan residents. Policies are needed to continue reducing these death rates and to address these disparities. Export

AV block prevalence increases with age: first-degree affects 6 % of adults over 60 with low mortality, second-degree is more serious, and third-degree, though rare (0.02 % in the U.S.), has a 37 % five-year survival rate if untreated. Analyzing mortality trends in second- or third-degree AV blocks in the U.S. is vital for treatment and identifying at-risk populations. We analyzed death certificates from the CDC WONDER database (1999–2022) for second- and third-degree AV Block (ICD-10 codes I44.1 and I44.2) in individuals aged 25 and older. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age, race/ethnicity and geographics. Between 1999 and 2022, 54,420 deaths were reported in patients with second- or third-degree AV block. The AAMR increased from 12.8 to 14.9, with a significant rise from 2013 to 2022 (APC: 7.26; 95 % CI: 6.13 to 9.96; p < 0.001). Older adults had higher AAMRs (45.0) compared to middle-aged (2.1) and young adults (0.3). Men had higher AAMRs than women (11.3 vs. 8.6). Ethnoracial disparities showed the highest AAMRs in NH American Indian individuals (13.3), followed by NH Black (10.5), NH White (9.8), Hispanic (7.3), and NH Asian individuals (5.9). Non-metropolitan areas had higher AAMRs than metropolitan areas (11.7 vs. 9.2). Mortality from second- and third-degree AV block has increased since 1999, particularly in the last decade, with higher rates in men, older adults, NH American Indian or Alaska Native individuals, and non-metropolitan areas, highlighting the need for further research to address these disparities.

Background Paroxysmal tachycardia encompasses various heart rhythm disorders that cause rapid heart rates. Its episodic occurrence makes it difficult to identify and measure its prevalence and trends in the population. Additionally, there is limited data on disparities and trends in mortality due to paroxysmal tachycardia, which is essential for assessing current medical approaches and identifying at-risk populations. Methods Our study examined death certificates from 1999 to 2020 using the CDC WONDER Database to identify deaths caused by paroxysmal tachycardia in individuals aged 25 and older, using the ICD-10 code I47. Age-adjusted mortality rates (AAMRs) and annual percent changes (APC) were calculated by year, gender, age group, race/ethnicity, geographic location, and urbanization status. Results Between 1999 and 2020, 155,320 deaths were reported in patients with paroxysmal tachycardia. Overall, AAMR decreased from 4.8 to 3.7 per 100,000 population between 1999 and 2020, despite showing a significant increase from 2014 to 2020 (APC: 4.33; 95% CI: 3.53 to 5.56). Men had consistently higher AAMRs than women (4.7 vs. 2.2). Furthermore, we found that AAMRs were highest among Non-Hispanic (NH) Black or African Americans and lowest in NH Asian or Pacific Islanders (4 vs. 1.9). Nonmetropolitan areas had higher AAMRs than metropolitan areas (3.6 vs. 3.2). Conclusions Our analysis showed a significant decrease in mortality from paroxysmal tachycardia since 1999, although there has been a slight increase in recent years. However, disparities remain, with higher AAMRs among men, NH Black or African Americans, and residents of non-metropolitan areas. These findings call for immediate public health actions to curb the rising trends and reduce potential disparities. Clinical Perspectives What is New? In this analysis of population-level US mortality data from 1999 to 2020, we observed an overall decrease in mortality due to Paroxysmal Tachycardia, despite a significant upward trend from 2014 to 2020. Older adults had higher age-adjusted mortality rates than young and middle-aged adults, and men had higher mortality rates than women. Non-Hispanic Black or African Americans had the highest mortality rates among racial groups, and those in non-metropolitan areas had higher rates than those in metropolitan areas. What Are the Clinical Implications? By addressing the effects of the pandemic and racial disparities, healthcare providers and policymakers can develop effective strategies to address this concerning trend. Education should not only identify risk factors but also work to change the socio-cultural conditions that cause these risks.