Abstract 18: Spatiotemporal and Demographic Trends in Cardiovascular Disease in the US Elderly Based on 108 Million Hospitalization Records
Background: The US population is rapidly aging, with concurrent increases in chronic disease burdens, particularly CVD. Yet, to-date, the spatial, temporal, and demographic distributions and trends in CVD incidence in the US elderly have not been characterized in detail using data with full coverage of this population.
Objective: To characterize trends, 1991-2004, in CVD hospitalizations among US elderly, by single year of age/ sex/race/county/state using records from US Centers for Medicare and Medicaid (CMS), which provide full coverage of the US population aged 65+.
Methods: We abstracted 108,357,431 hospitalization records compiled by CMS indicating CVD in any of 10 diagnosis codes, and tabulated total cases of CVD by sex, single year of age, state and calendar year (1991-2004). CVD incidence rates were calculated using stratum-specific population data from the US Census in conjunction with CMS records. We characterized distributions of CVD cases by single year of age for the US and further by state and calendar year, determining the sex-specific age at which the largest number of incident CVD cases were registered (peak age).
Results: CVD hospitalization rates increased from 1991-2004 for women aged 65-90 and men aged 65-80, but declined in the oldest-old. In 1991, CVD hospitalization rates for women aged 75 were 48 per 100,000 population, rising to 70 per 100,000 in 2004; men aged 75 had rates of 66 per 100,000 in 1991 versus 87 per 100,000 in 2004. Nationally, peak age of CVD hospitalizations increased 1991-2004, from 77 to 83 years of age for women and from 70 to 77 years of age for men. Men and women in Southern states had among the lowest peak ages of CVD in the nation in 1991 as well as 2004. (Figure) Trends by race/CVD subtype are forthcoming.
Conclusions: Emerging national trends and regional heterogeneity in CVD hospitalization rates and peak age of CVD hospitalization in the US elderly emphasize the need for targeted population-level policy/interventions to reduce CVD burdens and promote healthy aging.
Author Disclosures: G.M. Singh: None. M. Cruz: None. J.L. Peñalvo: None. J. Zhang: None. D. Mozaffarian: E. Honoraria; Modest; ad hoc honoraria or consulting from Boston Heart Diagnostics, Haas Avocado Board, Astra Zeneca, GOED, DSM, and Life Sciences Research Organization; and chapter royalties from UpToDate. E.N. Naumova: None.
- © 2017 by American Heart Association, Inc.