MON-442 - Trends and Disparities in Thyroid-Related Mortality in Patients with Cardiovascular Disease in the United States, 2000-2023: A CDC WONDER Database Analysis

Trends and Disparities in Thyroid-Related Mortality in patients with cardiovascular disease in the United States, 2000–2023: A CDC WONDER Database Analysis
Abstract:

Background:
Thyroid hormones play a major role in regulating the metabolism of human body. Its disorders - hypothyroidism and hyperthyroidism - and neoplasms cause significant mortality across the board. Combined with cardiovascular disease, its impact deepens. In this study we aim to analyses the trends of mortality in adults due to thyroid disorders including hyperthyroidism, hypothyroidism and thyroid cancer in patients with cardiovascular disease.

Methods:
Data was extracted from the CDC WONDER database, from 2000 to 2023 using ICD-10 for recognition of Thyroid disorders (E00 – E07), hyperthyroidism (E05), hypothyroidism (E01-E03), and malignant neoplasms of the thyroid gland (C73). Patients with cardiovascular disease were also identified using ICD-10(I00 -I99). Age-adjusted mortality rates (AAMRs) per 1,000,000 were stratified by year, gender, race/ethnicity, state of residence, and urbanization status.

Results:
From 2000–2023, 498,841 deaths were attributed to thyroid-related causes in patients with cardiovascular disease, primarily driven by hypothyroidism (n=450,478), followed by hyperthyroidism (n=31,422) and other causes. In patients aged >65, hyperthyroidism was the leading cause of thyroid-related mortality. Overall mortality due to thyroid disorders was stable from 2000–2019 (APC = -0.28, 95% CI: -0.54 to -0.02) before a rapid, non-significant increase through 2021 (APC = 14.27, 95% CI: -37.08 to 107.52). Females (AAMR = 109.9) exhibited nearly double the mortality rate of males (AAMR = 61.6). Non Metropolitan areas (AAMR = 108.6) faced higher mortality compared to Metropolitan areas (AAMR = 84.2). While the White population had the highest overall AAMR (97.7), Black populations were most affected by hyperthyroid-related mortality (AAMR = 9.22). Conversely, thyroid cancer mortality showed a significant, steady increase throughout the study period (APC = +2.23, 95% CI: +1.74 to +2.71) with no gender disparity (AAMR 3.5 for both).

Conclusion: Higher proportion of deaths by hypothyroidism in under-65 population underlines the need for screening and awareness of its symptoms in patients with cardiovascular disease. The disparity in AAMR between genders showcases the need to focus on female population especially in the non-metropolitan areas. Rising trends of thyroid cancer in this group warrants the further need to study its environmental and other drivers.
Keywords:
Hyperthyroidism, Hypothyroidism, Thyroid cancer, CDC WONDER, Disparities

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