Mult Scler Relat Disord. 2025 Nov 14;105:106861. doi: 10.1016/j.msard.2025.106861. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiovascular disease (CVD) is a significant cause of mortality among individuals with Multiple Sclerosis (MS) due to overlapping risk factors. However, national mortality trends involving both conditions have not been comprehensively explored. Understanding these patterns is crucial for developing evidence-based interventions and allocating healthcare resources effectively.
OBJECTIVE: To study the mortality trends in MS and associated cardiovascular disease among adults in the United States.
METHODS: Data from CDC WONDER (1999-2023) identified U.S. mortality rates in adults aged 25 and older with MS (ICD-10: G35) and cardiovascular disease (ICD-10: I00-I99) as multiple causes of death. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).
RESULTS: Between 1999 and 2023, a total of 53,903 deaths among adults (+25) were attributed to MS and cardiovascular disease. The AAMR (1999-2023) significantly increased from 0.78 to 1.21 (AAPC: 1.50, 95 % CI: 1.13 to 1.86; p < 0.001), with a significant rise from 2018 (0.87) to 2021 (1.24) (APC: 12.83; p = 0.02). Sex-stratified trends showed higher mortality in women (35,157) than in men (18,746), with higher AAMR in women (0.95 in 1999 to 1.45 in 2023 vs. 0.63 to 0.92). Non-metropolitan regions experiencing a higher overall AAMR than in metropolitan areas (0.92 vs. 0.88). Racially, the highest number of deaths was observed in the NH White (45,242). However, NH Black had the highest AAMR (1.59) in 2020. Geographically, the South had the sharpest rise (AAPC: 2.57, p < 0.001), and the highest deaths (15,384). Regarding age, the highest number of deaths occurred in the +65 age group (30,974) with a significant rise in AAMR from 2.19 in 1999 to 4.17 in 2023 (AAPC: 2.56; p < 0.001).
CONCLUSION: Mortality trends in MS and cardiovascular disease have increased in recent years. Higher trends were observed in women, non-metropolitan areas, the South region, and the non-Hispanic Black population.
PMID:41308235 | DOI:10.1016/j.msard.2025.106861