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CVD Mortality Higher in Women With Inflammatory Diseases
Although cardiovascular disease (CVD)-related mortality decreased significantly from 1999 to 2020 in both men and women with immune-mediated inflammatory diseases (IMIDs), women consistently had higher rates of CVD-related mortality than men over the 22-year period.
METHODOLOGY:
Researchers analyzed CDC Multiple Cause of Death files from 1999 to 2020 to assess the sex differences in CVD-related mortality in patients with IMIDs.
They identified CVD-related deaths with underlying IMIDs in the United States using diagnostic codes.
IMIDs such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis were analyzed.
The analysis included 281,355 IMID-related deaths and 127,149 CVD-related deaths over a period of 22 years.
Annual crude and adjusted death rates were estimated.
TAKEAWAY:
Age-adjusted CVD-related mortality for women with IMIDs declined from 3.3 per 100,000 in 1999 to 1.4 per 100,000 in 2020, whereas the rate in men with IMIDs declined from 2.3 to 1.1 per 100,000 ( P < .01).
< .01). However, women had higher mortality than men throughout the study duration (mortality rate ratio, 1.5; P < .01).
< .01). Cerebrovascular disease and ischemic heart disease were major causes of death, with women more affected than men; women experienced mortality from arrhythmia and cardiac arrest at more than twice the rate of men.
Among patients with IMIDs, women with rheumatoid arthritis had disproportionately higher crude CVD-related mortality than men with rheumatoid arthritis.
IN PRACTICE:
'Addressing these risks requires increasing awareness of atypical cardiovascular symptoms in females with IMIDs, enhancing early detection through advanced imaging, and ensuring equitable access to therapies like biologics,' the study authors wrote.
SOURCE:
This study was led by Issam Motairek, MD, Cleveland Clinic, Cleveland. It was published online on May 5, 2025, in Circulation: Cardiovascular Quality and Outcomes .
LIMITATIONS:
The potential inaccuracies in the codes for identifying the cause of death may have misclassified IMIDs or CVD-related causes. The aggregate data structure prevented the analyses of individual-level factors such as severity of disease or treatments. Less common IMIDs were excluded, which may have underestimated their contribution to CVD.
DISCLOSURES:
This study received no specific funding. The authors reported having no conflicts of interest.
