A66-05 Trends and Disparities in Mortality Due to Pulmonary Hypertension Contributed by Sleep Apnea in the United States, 1999-2020

Abstract Background Pulmonary hypertension (PH) and sleep apnea are interrelated cardiopulmonary disorders with growing clinical importance. While both conditions are increasingly recognized, national trends in PH-related mortality with sleep apnea is a contributing factor remain poorly defined. Methods We analyzed mortality data from the CDC WONDER Multiple Cause of Death database (1999-2020). Cases were identified using ICD-10 codes for PH (I27.0, I27.2, I27.8, I27.9) as the underlying cause and sleep apnea (G47.3) as a contributing cause. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Temporal trends were assessed using Joinpoint regression to estimate the average annual percent change (AAPC) with 95% confidence intervals (CI). Results Between 1999 and 2020, 4,874 deaths were attributed to PH with sleep apnea as a contributing cause (AAMR 0.19 per 100,000). Overall mortality increased significantly (AAPC +2.9%, 95% CI 2.0-4.7, p = 0.002). AAMRs were similar in males (0.20) and females (0.21), but mortality rose more sharply in females (AAPC +4.1%, 95% CI 2.7-6.4) compared with males (AAPC +0.8%, 95% CI -0.6-2.3). Black individuals had the highest AAMR (0.33) but stable trends (AAPC +0.2%, 95% CI -1.2-2.0), whereas White individuals had the lowest AAMR (0.19) yet the steepest increase (AAPC +4.6%, 95% CI 3.3-7.3). Non-metropolitan areas showed significant increases (AAPC +2.7%, 95% CI 1.2-4.3) compared with metropolitan regions (AAPC +1.4%, 95% CI -0.3-3.5). Conclusion PH-related mortality with sleep apnea as a contributing factor has risen substantially in the U.S. over two decades, with marked sex, racial, and geographic disparities. Better screening and management of sleep-disordered breathing in high-risk groups may help lessen this developing problem. This abstract is funded by: NA