Demographics and Trends of Hypertrophic Cardiomyopathy-Related Mortality in the United States, 1999-2020

There are limited data on the mortality trends of HCM in the United States. To study the demographics and trends of mortality in patients with HCM, a retrospective cohort analysis was done with mortality data of patients with HCM listed as an underlying cause of death in the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (CDCWONDER) from January 1999 to December 2020. The analysis took place in February 2022. First, we measured HCM-related age-adjusted mortality rate (AAMR) per 100,000 US population stratified by sex, race, ethnicity, and geographic area. We then calculated the Annual Percentage Change (APC) for AAMR for each. A total of 24,655 HCM-related deaths occurred between 1999 and 2020. The AAMR for HCM-related deaths declined from 0.5/100,000 patients in 1999 to 0.2 in 2020. The APC changes are as follows: -6.8 (95% CI: -11.8 to -1.5) from 2002 to 2009, -1.23 (95% CI -13.8 to 13.2) from 2009 to 2014, -6.71 (95% CI -46.2 to 61.7) from 2014 to 2017 and remained at 2.07 (95% CI -26.1 to 41.1) from 2017 to 2020. Men had consistently higher AAMR than women. Overall, AAMR in men was 0.4 (95% CI: 0.4-0.5), and in women was 0.3 (95% CI: 0.3-0.3). A similar trend was noticed in men and women over the years, starting from 1999 (AAMR men: 0.7 and women: 0.4) to 2020 (AAMR men: 0.3 and women: 0.2). AAMRs were highest among black or African American patients 0.6 (95% CI: 0.5-0.6), followed by non-Hispanic and Hispanic white 0.3 (95% CI 0.3-0.3) and Asian or Pacific Islander 0.2 (95% CI 0.2-0.2). There was substantial variation in each region in the US. States such as California, Ohio, Michigan, Oregon, and Wyoming had the highest AAMR. Large metro-politan cities had higher AAMR than non -metropoli-tan cities. During the study period from 1999 to 2020, HCM-related mortality steadily decreased. The high-est AAMR was observed among men, black patients, and residents of metropolitan areas. States such as California, Ohio, Michigan, Oregon, and Wyoming had the highest AAMR. (Curr Probl Cardiol 2023;48:101681.)