Work

Trends in Mortality-Related to Peripheral Artery Disease and Chronic Obstructive Pulmonary Disease Comorbidity in the United States (1999–2023)

Year: 2025

Type: article

Abstract: BACKGROUND: Peripheral artery disease (PAD) and chronic obstructive pulmonary disease (COPD) often coexist, contributing to elevated mortality due to shared etiologic factors such as tobacco use, chronic systemic inflammation, and aging-related vascular degeneration. National trends in the combined burden of PAD and COPD remain under-investigated. This study aims to demonstrate trends and demographic patterns in deaths associated with both COPD and PAD in the United States from 1999 to 2023. METHODS: Mortality data from 1999 to 2023 were extracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database using International Classification of Diseases, Tenth Revision codes corresponding to PAD and COPD (I70.x and I73.9 for PAD and J40-J44 for COPD). Data from the Multiple Cause of Death Public Use Record were used to identify death certificates that listed both PAD and COPD simultaneously, whether as the underlying or contributing cause of death. Age-adjusted mortality rates (AAMRs) were calculated, stratified by age group, sex, race, state, urbanization, and region. Joinpoint regression analysis was used to evaluate trends and annual percent changes (APCs) and average annual percent change. RESULTS: A total of 283,974 deaths were reported among individuals with coexisting PAD and COPD, with an overall AAMR of 5.50. AAMRs declined significantly between 2001 and 2017 (APC: -3.06%, 95% confidence interval [CI]: -3.41, -2.72) but rose from 2017 to 2021 (APC: 5.72%, 95% CI: 1.85, 9.73). Males had a higher overall AAMR than females (7.84 vs. 4.25). The White population had the highest race-specific AAMR (6.13), and crude rates were highest in the 65+ age group (24.8). Geographically, West Virginia reported the highest state-level AAMR (10.51) (95% CI: 10.16-10.86). Nonmetropolitan areas had higher mortality rates (7.2) compared to metropolitan areas (5.11). Regionally, the Midwest exhibited the highest AAMR (6.42). CONCLUSION: Although overall mortality related to PAD and COPD declined from 1999 to 2023, recent increases-particularly among older adults, males, the rural population, and specific geographic regions-highlight persistent disparities. While mortality from PAD or COPD alone has continued to decline, recent years have shown a reversal in patients with coexisting PAD and COPD, where mortality is rising disproportionately compared with either disease in isolation. These findings underscore the importance of continued surveillance and targeted chronic disease interventions to reduce mortality in high-risk populations.

Source: Annals of Vascular Surgery

DOI: 10.1016/j.avsg.2025.09.049