Trends in age-specific and sex-specific pulmonary hypertension mortality in Italy between 2005 and 2017

Abstract

Aims: Data regarding the pulmonary hypertension (PH)-related mortality and relative trends in the Italian population remain scant. We sought to assess the PH mortality rates and relative trends among the Italian population between 2005 and 2017.

Methods: Data regarding the cause-specific mortality and population size by sex in 5-year age groups were extracted from the WHO global mortality database. The age-standardized mortality rates, with relative 95% confidence intervals (CIs), also stratified by sex, were using the direct method. Joinpoint regression analyses were used to identify periods with statistically distinct log linear trends in PH-related death rates. To calculate nationwide annual trends in DCM-related mortality, we assessed the average annual percentage change (AAPC) and relative 95% CIs.

Results: In Italy, the PH age-standardized annual mortality rate decreased from 2.34 (95% CI: 2.32-2.36) deaths per 100 000 to 1.51 (95% CI: 1.48-1.53) deaths per 100 000 population. Over the entire period, men had higher PH-related mortality rates than women. Moreover, the PH-related mortality trend rose with a seemingly exponential distribution with a similar trend among male and female individuals. Joinpoint regression analysis revealed a linear significant decrease in age-standardized PH-related mortality from 2005 to 2017 [AAPC: -3.1% (95% CI: -3.8 to -2.5), P < 0.001] in the entire Italian population. However, the decline was more pronounced among men [AAPC: -5.0 (95% CI: -6.1 to -3.9), P < 0.001] compared with women [AAPC: -1.5 (95% CI: -2.3 to -0.7), P = 0.001].

Conclusion: In Italy, the PH-related mortality rates linearly declined from 2005 to 2017.