Background/Purpose: Inflammatory polyarthropathy (IPA) is a group of chronic autoimmune disorders, common among older adults and contribute significantly to systemic inflammation and cardiovascular risk . These conditions are associated with systemic inflammation, which leads to an elevated risk of cardiovascular diseases, notably hypertension (HTN). Recent studies suggest that people with IPA like rheumatic arthritis (RA) are 48% more likely to develop cardiovascular disorders than the general population. Emerging research underscores the role of immune-mediated inflammation in pathogenesis of HTN among patients with IPA. This study explores mortality rates due to IPA in patients with (HTN) patients aged 55 or above to inform prevention and care strategies.

Methods: We conducted a retrospective population-based study using the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research system (CDC WONDER) death certificate data (1999-2020). Subjects with Inflammatory polyarthropathy and Hypertension (HTN) were selected. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, and trends were assessed using Joinpoint regression to estimate annual and average annual percent changes (APC, AAPC). Rates were stratified by year, gender, race/ethnicity, region, and urbanization.

Results: A total of 91,168 deaths were reported to be associated with Inflammatory polyarthropathy and hypertension between 1999-2020, of which males accounted for 35.68% and female accounted for 64.32%. The overall age-adjusted mortality rate (AAMR) increased from 3.01 in 1999 to 7.46 in 2020 (AAPC: 2.78, p < 0.050810). Females had a higher age-adjusted mortality rate than males (6.15 vs 5.17). Racial/ethnic disparities were apparent. Black or African American population had the highest AAMR (10.97 in 2020) (AAPC: 1.12, p < 0.565390). Asian or Pacific Islander had an overall similar trend (AAPC: -0.67, p < 0.170487). The trend in White people (AAPC: 2.90, p < 0.017643) remained almost consistent with sudden spike in 2020 (AAMR 7.18). Hispanic people had an overall upward trend (AAPC: 3.03, p < 0.013721).Geographically, all four U.S. Census regions showed statistically significant incline, most prominent in the Northeast (AAPC: 4.03) and South (AAPC: 2.75) regions.Both Urban and rural populations witnessed a substantial rise, however, it was more pronounced in rural population (AAPC: 3.30, p < 0.021351) as compared to urban (AAPC: 2.50, p < 0.083213)

Conclusion: Over the last 2 decades, mortality due to inflammatory polyarthropathy in patients with hypertension has remarkably increased. These findings highlight the need for targeted public health interventions and equitable access to address these disparities.

Figure 1: showing an overall increase in mortality trend due to Inflammatory Polyarthropathy and Hypertension

Figure 2: Showing disparities in mortality trends between sexes, with constant rise seen in males, and females demonstrating a biphasic pattern

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mortality-trends-due-to-hypertension-related-deaths-in-elderly-patients-with-inflammatory-polyarthropathy-a-cdc-wonder-analysis-of-21-years/