Table 4.
Trends in Cardiovascular Disease Mortality Between Hispanic and Non‐Hispanic White Adults in the United States Stratified by Urban‐Rural Counties, 1999 to 2018
| Hispanic adults | Non‐Hispanic White adults | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Age‐adjusted mortality rate (95% CI) | AAPC (95% CI) | Age‐adjusted mortality rate (95% CI) | AAPC (95% CI) | Test for parallelism | |||||
| 1999 | 2011 | 2018 | (1999–2018) | 1999 | 2011 | 2018 | (1999–2018) | P value | |
| Total cardiovascular disease | |||||||||
| Large metro | 265.4 (261.8–269.0) | 164.9 (162.8–166.9) | 156.0 (154.4–157.6) | −2.79 (−3.16 to −2.41) | 320.0 (318.9–321.0) | 202.5 (201.7–203.3) | 191.3 (190.5–192.0) | −2.64 (−3.11 to −2.18) | <0.001 |
| Medium‐small metro | 262.5 (256.4–268.6) | 169.4 (166.0–172.7) | 158.2 (155.6–160.9) | −2.56 (−3.04 to −2.07) | 316.1 (314.8–317.4) | 209.7 (208.8–210.7) | 201.5 (200.6–202.4) | −2.33 (−2.72 to −1.95) | <0.001 |
| Rural | 307.6 (295.7–319.5) | 172.6 (166.1–179.1) | 158.1 (152.9–163.2) | −3.05 (−3.68 to −2.43) | 340.0 (338.3–341.6) | 236.7 (235.3–238.0) | 227.0 (225.8–228.3) | −2.13 (−2.32 to −1.94) | <0.001 |
| Ischemic heart disease | |||||||||
| Large metro | 166.7 (163.8–169.5) | 85.7 (84.2–87.2) | 68.3 (67.3–69.4) | −4.65 (−5.07 to −4.22) | 201.1 (200.3–202.0) | 109.2 (108.6–109.7) | 89.2 (88.7–89.7) | −4.18 (−4.59 to −3.76) | <0.001 |
| Medium‐small metro | 146.4 (141.9–150.9) | 79.4 (77.1–81.7) | 70.6 (68.8–72.4) | −3.78 (−4.36 to −3.20) | 182.7 (181.7–183.7) | 107.1 (106.4–107.8) | 91.3 (90.7–91.9) | −3.63 (−3.95 to −3.31) | <0.001 |
| Rural | 171.6 (162.7–180.4) | 86.4 (81.8–91.0) | 71.7 (68.3–75.2) | −4.21 (−4.93 to −3.47) | 196.8 (195.6–198.1) | 122.7 (121.8–123.7) | 108.3 (107.4–109.2) | −3.15 (−3.36 to −2.94) | <0.001 |
| Heart failure | |||||||||
| Large metro | 9.3 (8.6–10.0) | 9.6 (9.1–10.1) | 11.7 (11.2–12.1) | 1.37 (0.87–1.88) | 17.5 (17.3–17.7) | 16.0 (15.8–16.2) | 21.2 (20.9–21.4) | 1.08 (0.44–1.72) | <0.001 |
| Medium‐small metro | 13.1 (11.7–14.6) | 10.2 (9.4–11.1) | 11.5 (10.8–12.3) | −0.30 (−1.87 to 1.29) | 21.2 (20.8–21.5) | 17.5 (17.2–17.7) | 21.2 (20.9–21.4) | 0.04 (−0.50 to 0.58) | 0.72 |
| Rural | 21.3 (18.0–24.6) | 13.9 (12.0–15.8) | 15.0 (13.4–16.7) | −1.50 (−5.25 to 2.41) | 26.8 (26.4–27.3) | 21.1 (20.7–21.5) | 24.1 (23.7–24.5) | −0.60 (−1.16 to −0.04) | 0.02 |
| Hypertensive heart disease | |||||||||
| Large metro | 7.4 (6.9–8.0) | 7.9 (7.4–8.3) | 10.4 (10.0–10.8) | 1.95 (0.56–3.35) | 7.4 (7.3–7.6) | 9.3 (9.1–9.4) | 12.0 (11.8–12.2) | 2.62 (2.06–3.18) | <0.001 |
| Medium‐small metro | 6.2 (5.2–7.1) | 8.2 (7.5–9.0) | 8.8 (8.2–9.4) | 0.96 (0.34–1.59) | 6.7 (6.5–6.9) | 8.2 (8.0–8.4) | 12.4 (12.2–12.7) | 2.86 (2.29–3.44) | <0.001 |
| Rural | 4.9 (3.5–6.6) | 5.0 (4.0–6.3) | 6.0 (5.0–6.9) | 1.37 (0.16–2.60) | 5.6 (5.4–5.8) | 7.2 (7.0–7.4) | 11.5 (11.3–11.8) | 3.94 (3.51–4.36) | <0.001 |
| Stroke | |||||||||
| Large metro | 43.4 (42.0–44.9) | 29.1 (28.3–30.0) | 32.6 (31.8–33.3) | −1.71 (−2.25 to −1.18) | 56.2 (55.7–56.6) | 33.5 (33.2–33.8) | 34.3 (34.0–34.6) | −2.53 (−3.33 to −1.72) | <0.001 |
| Medium‐small metro | 51.6 (48.9–54.3) | 34.5 (32.9–36.0) | 31.3 (30.1–32.5) | −2.64 (−3.10 to −2.18) | 61.6 (61.0–62.1) | 37.9 (37.5–38.3) | 36.4 (36.1–36.8) | −2.70 (−3.22 to −2.18) | <0.001 |
| Rural | 60.2 (54.9–65.5) | 32.8 (30.0–35.7) | 29.0 (26.8–31.2) | −3.76 (−5.00 to −2.51) | 65.7 (64.9–66.4) | 42.5 (42.0–43.1) | 38.8 (38.2–39.3) | −2.70 (−3.12 to −2.28) | <0.001 |
| Other cardiovascular diseases | |||||||||
| Large metro | 21.8 (20.9–22.8) | 19.3 (18.7–20.0) | 18.5 (18.0–19.1) | −0.53 (−0.72 to −0.34) | 37.7 (37.4–38.1) | 34.6 (34.3–34.9) | 34.6 (34.3–34.9) | −0.38 (−0.79 to 0.03) | 0.02 |
| Medium‐small metro | 25.6 (23.7–27.4) | 22.3 (21.1–23.5) | 20.1 (19.1–21.0) | −1.17 (−1.48 to −0.86) | 43.9 (43.5–44.4) | 39.1 (38.7–39.5) | 40.2 (39.8–40.6) | −0.35 (−0.67 to −0.03) | <0.001 |
| Rural | 30.1 (26.7–33.5) | 22.1 (19.9–24.4) | 24.4 (22.4–26.4) | −1.16 (−2.28 to −0.02) | 45.0 (44.4–45.6) | 43.1 (42.5–43.6) | 44.3 (43.7–44.9) | −0.02 (−0.35 to 0.31) | 0.09 |
AAPC indicates average annual percent change.