Abstract WP156: Double Trouble: Two Decades of Mortality Trends in Chronic Obstructive Pulmonary Disease Associated Stroke Among Elderly Americans.

Introduction: Stroke and Chronic obstructive pulmonary disease (COPD) are among the leading causes of death globally, accounting for millions of fatalities and substantial disability each year. Having both conditions increases the risks due to shared factors, such as inflammation, hypoxia, and vascular abnormalities. Patients with COPD face a higher likelihood of strokes, particularly after exacerbations. This research uses CDC data to examine mortality trends and disparities in individuals aged 55 and older with both COPD and stroke from 1999 to 2020. Methods: A retrospective analysis of CDC-WONDER mortality data (1999-2020) in the U.S. identified patients aged 55 and older with COPD who had a stroke, using Multiple cause of death ICD-10 codes J44, I60, I61, I63, and I64. Results were stratified demographically and geographically. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated with 95% CI. Annual percent change (APC) and average annual percent change (AAPC) were determined using Joint-point regression. Results: From 1999 to 2020, there were 204,674 stroke-related deaths among COPD patients aged 55 years and older in the US. The overall AAMR declined sharply from 18.72 in 1999 to 12.84 in 2007 (APC: -4.72), followed by a slower decline to 10.70 until 2018 (APC: -2.03), after which it increased to 12.26 in 2020 (APC: 7.33). Men had higher AAMRs (16.09) compared to women (10.99). Non-Hispanic (NH) Whites had the highest AAMR (13.92), followed by NH American Indians/Alaska Natives (13.40), NH Blacks (12.71), Hispanics (6.80), and Asian/Pacific Islanders (5.24). Geographically, the South had the highest AAMR (14.41), followed by the Midwest (13.86), West (12.97), and Northeast (9.78). Additionally, the mortality rate was higher in rural areas (AAMR: 18.07) than in urban areas (AAMR: 11.97). Conclusion: Our analysis reveals a significant and often overlooked link between COPD and higher stroke-related death rates, emphasizing the importance of early vascular risk assessment in chronic pulmonary patients. These findings highlight the need for a multidisciplinary approach that combines pulmonology and stroke prevention, especially in resource-limited settings where the dual disease burden is increasing. Including COPD management in stroke risk models could provide a new way to lower global stroke deaths.