Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) mortality, but there are limited data on temporal trends disaggregated by sex, race, and urban/rural status in this population. Retrospective observational study. The Centers for Disease Control and Prevention Wide-Ranging, Online Data for Epidemiologic Research database. Patients with CKD and end-stage kidney disease (ESKD) stratified according to key demographic groups. Etiologies of CKD- and ESKD-associated mortality between 1999 and 2000. Presentation of age-adjusted mortality rates (per 100,000 people) characterized by CV categories, ethnicity, sex (male or female), age categories, state, and urban/rural status. Between 1999 and 2020, we identified 1,938,505 death certificates with CKD (and ESKD) as an associated cause of mortality. Of all CKD-associated mortality, the most common etiology was CV, with 31.2% of cases. Between 1999 and 2020, CKD-related age-adjusted mortality increased by 50.2%, which was attributed to an 86.6% increase in non-CV mortality but a 7.1% decrease in CV mortality. Black patients had a higher rate of CV mortality throughout the study period, although Black patients experienced a 38.6% reduction in mortality whereas White patients saw a 2.7% increase. Hispanic patients experienced a greater reduction in CV mortality over the study period (40% reduction) compared to non-Hispanic patients (3.6% reduction). CV mortality was higher in urban areas in 1999 but in rural areas in 2020. Reliance on accurate characterization of causes of mortality in a large dataset. Among patients with CKD-related mortality in the United States between 1999 and 2020, there was an increase in all-cause mortality though a small decrease in CV-related mortality. Overall, temporal decreases in CV mortality were more prominent in Hispanic versus non-Hispanic patients and Black patients versus White patients.

Aims: This study aims to investigate the trends in the global cardiovascular disease (CVD) burden attributable to smoking from 1990 to 2019. Methods and results: Global Burden of Disease Study 2019 was used to analyse the burden of CVD attributable to smoking (i.e. ischaemic heart disease, peripheral artery disease, stroke, atrial fibrillation and flutter, and aortic aneurysm). Age-standardized mortality rates (ASMRs) per 100 000 and age-standardized disability-adjusted life year rates (ASDRs) per 100 000, as well as an estimated annual percentage change (EAPC) in ASMR and ASDR, were determined by age, sex, year, socio-demographic index (SDI), regions, and countries or territories. The global ASMR of smoking-attributed CVD decreased from 57.16/100 000 [95% uncertainty interval (UI) 54.46–59.97] in 1990 to 33.03/100 000 (95% UI 30.43–35.51) in 2019 [EAPC −0.42 (95% UI −0.47 to −0.38)]. Similarly, the ASDR of smoking-attributed CVD decreased between 1990 and 2019. All CVD subcategories showed a decline in death burden between 1990 and 2019. The burden of smoking-attributed CVD was higher in men than in women. Significant geographic and regional variations existed such that Eastern Europe had the highest ASMR and Andean Latin America had the lowest ASMR in 2019. In 2019, the ASMR of smoking-attributed CVD was lowest in high SDI regions. Conclusion: Smoking-attributed CVD morbidity and mortality are declining globally, but significant variation persists, indicating a need for targeted interventions to reduce smoking-related CVD burden.

Background: There are limited data on substance use (SU) and cardiovascular disease (CVD)–related mortality trends in the United States. We aimed to evaluate SU+CVD–related deaths in the United States using the Centers for Disease Control and Prevention Wide‐Ranging, Online Data for Epidemiologic Research database. Methods and Results: The Multiple Cause‐of‐Death Public Use record death certificates were used to identify deaths related to both SU and CVD. Crude, age‐adjusted mortality rates, annual percent change, and average annual percent changes with a 95% CI were analyzed. Between 1999 and 2019, there were 636 572 SU+CVD‐related deaths (75.6% men, 70.6% non‐Hispanic White individuals, 65% related to alcohol). Age‐adjusted mortality rates per 100 000 population were pronounced in men (22.5 [95% CI, 22.6–22.6]), American Indian or Alaska Native individuals (37.7 [95% CI, 37.0–38.4]), nonmetropolitan/rural areas (15.2 [95% CI, 15.1–15.3]), and alcohol‐related death (9.09 [95% CI, 9.07 to 9.12]). The overall SU+CVD‐related age‐adjusted mortality rates increased from 9.9 (95% CI, 9.8–10.1) in 1999 to 21.4 (95% CI, 21.2–21.6) in 2019 with an average annual percent change of 4.0 (95% CI, 3.7–4.3). Increases in SU+CVD‐related average annual percent change were noted across all subgroups and were pronounced among women (4.8% [95% CI, 4.5–5.1]), American Indian or Alaska Native individuals, younger individuals, nonmetropolitan areas, and cannabis and psychostimulant users. Conclusions: There was a prominent increase in SU+CVD‐related mortality in the United States between 1999 and 2019. Women, non‐Hispanic American Indian or Alaska Native individuals, younger individuals, nonmetropolitan area residents, and users of cannabis and psychostimulants had pronounced increases in SU+CVD mortality.

The multiple cause of death files available through the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) present underlying and contributing causes of mortality. We sought to evaluate potential differences in mortality reporting that may occur based on utilization of only underlying versus utilization of both underlying and contributing cause of mortality. All-cause and top 5 underlying causes of deaths in individuals ≥25 years of age from 2011 to 2019 occurring within United States were extracted from CDC WONDER. Deaths for the top 5 underlying causes of death as underlying and as underlying or contributing causes were extracted. For each cause, we calculated the percentage of the deaths that would be reported if only the underlying versus the underlying or contributing mortality was reported. Between 2011 and 2019, the top 5 underlying causes of mortality were heart disease, malignant neoplasm, chronic lower respiratory disease, cerebrovascular disease, and accidents. For these causes, the percentages of deaths presented by reporting (underlying)/(underlying or contributing) causes were 53 %, 91 %, 50 %, 59 %, and 79 % respectively. Data within the commonly utilized multiple cause of death files from CDC WONDER demonstrate that reliance solely on the underlying cause of mortality may underestimate important contributions of common contributing causes. These findings could aid in the understanding of published research and may shape the framework for future studies utilizing multiple cause of death data through CDC WONDER.