# Temporal Trends in Cardiovascular Mortality in Underlying Viral Hepatitis: A Retrospective Analysis of Gender, Racial/Ethnic, and Regional Disparities

## TL;DR

This study examines how deaths from cardiovascular disease and viral hepatitis have changed over time, highlighting disparities by race, age, and location.

## Contribution

The study provides new insights into recent declines in mortality linked to cardiovascular disease and viral hepatitis, especially in urban areas.

## Key findings

- The overall age-adjusted mortality rate increased from 15.2 in 1999 to 24.9 in 2020, but declined from 2013 to 2020.
- African Americans had more than twice the mortality rate of Whites (AAMR: 20.3).
- Urban areas showed higher mortality rates than rural areas, with a significant decline in urban AAMR from 2013 to 2020.

## Abstract

This study aimed to investigate contemporary trends in mortality related to cardiovascular disease and viral hepatitis.

We conducted a retrospective analysis using data from the CDC‐WONDER dataset. Our study cohort consisted of adults aged ≥ 15 years, where both cardiovascular disease and viral hepatitis were identified as an underlying or contributory cause of death between 1999 and 2020. Crude and age‐adjusted mortality rates (AAMR) per 1 000 000 population were extracted. Joinpoint regression analysis was utilized to calculate annual percentage change (APC) of each trend.

The overall AAMR exhibited a notable increase from 15.2 in 1999 to 24.9 in 2020. However, a recent decline was observed from 2013 to 2020 (APC: −2.1; 95% confidence interval [CI]: −3.4 to 0.65). African Americans experienced the highest mortality rate, surpassing that of Whites by more than twofold (AAMR: 20.3). Middle‐aged adults (35–54 years) faced the greatest mortality burden among all other age groups. Urban–rural disparities were significant, with urban areas showing substantially higher AAMRs compared to rural areas. Notably, urban AAMR decreased between 2013 and 2020 (APC: −2.7).

The observed decrease in mortality related to cardiovascular disease and viral hepatitis over the past decade can be attributed to several factors, including heightened awareness and screening efforts, the introduction of novel and improved direct‐acting antiviral therapies, and the implementation of integrated public health models.