Abstract WP077: Trends and Disparities in Stroke-Related Mortality Among Adults with Peripheral Artery Disease in the United States: A CDC WONDER Analysis (1999-2023)

Background: Stroke remains a major cause of mortality in the United States, and outcomes are significantly worse in patients with peripheral artery disease (PAD), a systemic atherosclerotic condition affecting an estimated 7 to 12 million adults. PAD is strongly linked to increased stroke incidence, recurrent vascular events, and poor survival. However, national trends in stroke mortality in patients with PAD have not been completely described. Understanding these long-term patterns is essential to guide preventive and targeted intervention in this high-risk group. Hypothesis: We hypothesized that stroke-related mortality in PAD declined but remained higher in males, Black or African American individuals, the South, and rural areas. Methods: With CDC WONDER data, we determined deaths in 1999–2023 with stroke as the underlying cause and PAD as a contributing cause. Age-adjusted mortality rates (AAMRs) per 100,000 population were computed using the 2000 U.S. Average annual percent change (AAPC) with 95% confidence intervals (CIs) was estimated using Joinpoint regression. Statistical significance was defined as p < 0.05. Subgroup analyses were stratified by sex, race and ethnicity, census region, metropolitan status, and state. Results: From 1999 to 2023, there were 178,883 deaths from stroke in patients with PAD. The national AAMR decreased from 5.23 in 1999 to 1.43 in 2023, with an AAPC of -5.70% (95% CI: -6.52 to -4.88).Mortality was higher in men than in women (3.61 vs 3.34). By ethnicity and race, mortality was highest in Black or African American (3.81), then White (3.48), Hispanic or Latino (2.78), and Asian or Pacific Islander (2.33). Regionally, the West (4.45) and Midwest (3.79) showed the highest mortality, followed by the South (3.41), and the Northeast (2.29) had the lowest. Mortality rates in nonmetropolitan regions were higher than in metropolitan areas (4.49 vs. 3.30). Across states, mortality was greatest in Iowa (7.05) and Arizona (6.32), whereas Massachusetts reported the lowest rate (1.91). Conclusion: Stroke mortality among PAD patients decreased in the United States during the last two decades, but disparities remain.Rural residents, those from the West and Midwest, Black people, and men are still disproportionately affected. These results emphasize the importance of equitable prevention, increased detection of PAD at an earlier stage, and improved access to acute and secondary stroke therapy in high-risk populations.