DOI: 10.1161/circ.148.suppl_1.17828 ISSN: 0009-7322

Abstract 17828: Sex Differences in Mortality Trends of Rheumatic Heart Disease in High-Income Countries

Makoto Hibino, Junichi Shimamura, Raj Verma, Nitish Dhingra, bobby Yanagawa, Deepak Bhatt, Subodh Verma
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Rheumatic heart disease has traditionally been considered to be more prevalent among females; however, current trends in mortality in each sex are unclear in high-income countries.

Hypothesis: We hypothesized that mortality from rheumatic heart disease is higher among females but has improved in both sexes in high-income countries.

Methods: We analyzed the WHO mortality database to determine trends in mortality from rheumatic heart disease in the UK, Germany, France, Italy, Japan, Australia, the USA, and Canada from 2000 to 2020. Sex-specific age-standardized mortality rates per 100,000 persons were calculated and compared by using female-to-male ratio. Annual percentage change was analyzed using joinpoint regression.

Results: In the most recent year, female sex-specific age-standardized mortality rates were significantly higher in the UK (0.60 vs 0.44), Italy (1.24 vs 0.98), the USA (0.63 vs 0.47) and Canada (0.79 vs 0.57). Over the observation period, there was a trend to deceasing sex-specific age-standardized mortality rates in both sexes in the UK, France, Japan, and USA (p<0.01, respectively) and only in female sex in Italy and Australia (p<0.01, respectively), while the mortality rates in both sexes were constant in Canada and demonstrated increasing trends in Germany. Average female-to-male mortality rates ranged from 1.07 (95% CI, 1.02, 1.11) in France to 1.59 (95% CI, 1.51, 1.67) in the UK and were decreasing toward 1 with statistical significance in all countries (average annual change ranged from -1.6% to -0.6%) except for France.

Conclusions: Mortality from rheumatic heart disease in females exhibited a decreasing trend in the 6 studied high-income countries while increasing in Germany and constant in Canada. Female-dominated mortality was becoming less pronounced in the studied high-income countries, with the exception of France, which already had the lowest average female-dominant mortality rates.

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