P3641 - Temporal Trends in Cardiovascular Mortality in Underlying Viral Hepatitis: A Retrospective Analysis of Gender, Racial/Ethnic, and Regional Disparities

Wania Sultan, ¹, Ahmad Khan, ², Muhammad Omar Larik, MBBS¹, Haider Ashfaq, MBBS³, Maheen Zahid, MBBS⁴, Ayman Omair Hashmi, MBBS⁵, Hamza Ashraf, ³, Noma Nazir, MBBS⁶, Omar Al-Radideh, MD⁷, Ayesha Bhat, MBBS⁸
1Dow University of Health Sciences, Karachi, Sindh, Pakistan; 2Khyber Medical University, Peshawar, North-West Frontier, Pakistan; 3Allama Iqbal Medical College, Lahore, Punjab, Pakistan; 4Liaquat University of Medical and Health Science, Hyderabad, Sindh, Pakistan; 5Indus Hospital, Karachi, Sindh, Pakistan; 6Detroit Medical Center/Wayne State University, Detroit, MI; 7University of Florida College of Medicine, Gainesville, FL; 8Shaheed Suhrawardy Medical College, Muscat, Masqat, Oman

Introduction: Viral hepatitis, a leading global cause of mortality with rising deaths (1.4 million/year), drives cirrhosis and liver cancer. In the U.S. (2021), over 13,000 acute hepatitis B and 107,540 chronic hepatitis C cases were reported. Cardiovascular disease (CVD), the top U.S. killer, shares risk factors (diabetes, dyslipidemia) with liver disease, and hepatitis C/B are linked to atherosclerosis and coronary disease. Cirrhotic cardiomyopathy affects 50% of cirrhotic patients, further connecting these conditions. Despite progress, the Viral Hepatitis National Progress Report highlights unmet 2025 targets for reducing infections and deaths. Analyzing demographic and regional trends in hepatitis-related CVD mortality is critical to guide public health strategies and resource allocation in the U.S.

Methods: 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 underlying or contributory causes 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 the annual percentage change (APC) of each trend.

Results: 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).

Discussion: Our study demonstrates rising hepatitis-related cardiovascular mortality, with significant disparities among African Americans and middle-aged adults. While recent declines reflect therapeutic advances, persistent gaps highlight the need for targeted interventions in high-risk groups and improved cardiovascular screening in hepatitis patients.


Figure: Illustration: Mortality Trends and Disparities in Patients with Cardiovascular Disease and Viral Hepatitis.

Disclosures:
Wania Sultan indicated no relevant financial relationships.
Ahmad Khan indicated no relevant financial relationships.
Muhammad Omar Larik indicated no relevant financial relationships.
Haider Ashfaq indicated no relevant financial relationships.
Maheen Zahid indicated no relevant financial relationships.
Ayman Omair Hashmi indicated no relevant financial relationships.
Hamza Ashraf indicated no relevant financial relationships.
Noma Nazir indicated no relevant financial relationships.
Omar Al-Radideh indicated no relevant financial relationships.
Ayesha Bhat indicated no relevant financial relationships.

Wania Sultan, ¹, Ahmad Khan, ², Muhammad Omar Larik, MBBS¹, Haider Ashfaq, MBBS³, Maheen Zahid, MBBS⁴, Ayman Omair Hashmi, MBBS⁵, Hamza Ashraf, ³, Noma Nazir, MBBS⁶, Omar Al-Radideh, MD⁷, Ayesha Bhat, MBBS⁸. P3641 - Temporal Trends in Cardiovascular Mortality in Underlying Viral Hepatitis: A Retrospective Analysis of Gender, Racial/Ethnic, and Regional Disparities, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.