Pub Date : 2025-02-03DOI: 10.1016/j.amjmed.2025.01.035
Joshua D Bloomstein, Matthew S Wu, Robert C Doerning
{"title":"Treatment Dilemma in Acute Decompensated Heart Failure and Untreated Grave Disease.","authors":"Joshua D Bloomstein, Matthew S Wu, Robert C Doerning","doi":"10.1016/j.amjmed.2025.01.035","DOIUrl":"10.1016/j.amjmed.2025.01.035","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.amjmed.2025.01.031
Ji-Eun Kim, Jungnam Joo, Kayode O Kuku, Carolina Downie, Maryam Hashemian, Tiffany M Powell-Wiley, Joseph J Shearer, Véronique L Roger
Background: Cardiovascular-Kidney-Metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized.
Methods: Data from adults who completed the National Health and Nutrition Examination Survey between 2011-2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for Cardiovascular-Kidney-Metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages.
Results: Among 8,474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 was associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1,000 person-years.
Conclusion: Approximately 13% of adults were in advanced stages, which disproportionately affects non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies.
{"title":"Prevalence, Disparities, and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in US Adults, 2011-2018.","authors":"Ji-Eun Kim, Jungnam Joo, Kayode O Kuku, Carolina Downie, Maryam Hashemian, Tiffany M Powell-Wiley, Joseph J Shearer, Véronique L Roger","doi":"10.1016/j.amjmed.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.amjmed.2025.01.031","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-Kidney-Metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized.</p><p><strong>Methods: </strong>Data from adults who completed the National Health and Nutrition Examination Survey between 2011-2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for Cardiovascular-Kidney-Metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages.</p><p><strong>Results: </strong>Among 8,474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 was associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1,000 person-years.</p><p><strong>Conclusion: </strong>Approximately 13% of adults were in advanced stages, which disproportionately affects non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.amjmed.2024.08.027
Lawrence D. Hayes PhD , Ethan C.J. Berry BSc (Hons) , Nilihan E.M. Sanal-Hayes PhD , Nicholas F. Sculthorpe PhD , Duncan S. Buchan PhD , Marie Mclaughlin PhD , Sowmya Munishankar MBChB, MRCPsych, MSc , Debbie Tolson PhD
Background
Body composition, blood pressure, estimated maximal oxygen uptake (VO2max), lung function, physical activity, muscle architecture, and endothelial function had not previously been examined in people with young onset dementia. Therefore, the study measured these variables in a young onset dementia group, compared them to age-matched controls.
Methods
Estimated VO2max (via the Astrand-Rhyming test), body composition, blood pressure, lung function (via spirometry), muscle architecture (via ultrasonography), and endothelial function (via flow-mediated dilation) were assessed. Physical activity was measured using ActiGraph accelerometers for 7 days.
Results
We recruited 33 participants (16 young onset dementia, 17 controls). The young onset dementia group had shorter fascicle lengths of the vastus lateralis, were sedentary for longer over a 7-day period, and completed less moderate-vigorous physical activity than controls (P = .028, d = 0.81; large effect, P = .029, d = 0.54; moderate effect, and P = .014, d = 0.97; large effect, respectively for pairwise comparisons). Pairwise comparisons suggest no differences at the P < .05 level between young onset dementia and controls for estimated VO2max (despite a moderate effect size [d = 0.66]), height, body mass, BMI, blood pressure, light physical activity, lung function, muscle thickness, pennation angle, or endothelial function.
Conclusions
This study highlights differences between people with young onset dementia and controls, underscoring the need for multicomponent exercise interventions. Future interventions should target muscle architecture, increase moderate-vigorous physical activity, and reduce sedentariness, with the goal of improving quality of life and promoting functional independence.
{"title":"Body Composition, Vascular Health, Cardiorespiratory Fitness, Lung Function, Muscle Architecture, and Physical Activity in People with Young Onset Dementia: A Case-Control Study","authors":"Lawrence D. Hayes PhD , Ethan C.J. Berry BSc (Hons) , Nilihan E.M. Sanal-Hayes PhD , Nicholas F. Sculthorpe PhD , Duncan S. Buchan PhD , Marie Mclaughlin PhD , Sowmya Munishankar MBChB, MRCPsych, MSc , Debbie Tolson PhD","doi":"10.1016/j.amjmed.2024.08.027","DOIUrl":"10.1016/j.amjmed.2024.08.027","url":null,"abstract":"<div><h3>Background</h3><div>Body composition, blood pressure, estimated maximal oxygen uptake (VO<sub>2max</sub>), lung function, physical activity, muscle architecture, and endothelial function had not previously been examined in people with young onset dementia. Therefore, the study measured these variables in a young onset dementia group, compared them to age-matched controls.</div></div><div><h3>Methods</h3><div>Estimated VO<sub>2max</sub> (via the Astrand-Rhyming test), body composition, blood pressure, lung function (via spirometry), muscle architecture (via ultrasonography), and endothelial function (via flow-mediated dilation) were assessed. Physical activity was measured using ActiGraph accelerometers for 7 days.</div></div><div><h3>Results</h3><div>We recruited 33 participants (16 young onset dementia, 17 controls). The young onset dementia group had shorter fascicle lengths of the vastus lateralis, were sedentary for longer over a 7-day period, and completed less moderate-vigorous physical activity than controls (<em>P</em> = .028, <em>d</em> = 0.81; large effect, <em>P</em> = .029, <em>d</em> = 0.54; moderate effect, and <em>P</em> = .014, <em>d</em> = 0.97; large effect, respectively for pairwise comparisons). Pairwise comparisons suggest no differences at the <em>P</em> < .05 level between young onset dementia and controls for estimated VO<sub>2max</sub> (despite a moderate effect size [<em>d</em> = 0.66]), height, body mass, BMI, blood pressure, light physical activity, lung function, muscle thickness, pennation angle, or endothelial function.</div></div><div><h3>Conclusions</h3><div>This study highlights differences between people with young onset dementia and controls, underscoring the need for multicomponent exercise interventions. Future interventions should target muscle architecture, increase moderate-vigorous physical activity, and reduce sedentariness, with the goal of improving quality of life and promoting functional independence.</div></div>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 277-286.e1"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.amjmed.2024.09.010
Ami Schattner MD
{"title":"Unexpected Morbidity Following Influenza in Older People: Implications for Vaccination","authors":"Ami Schattner MD","doi":"10.1016/j.amjmed.2024.09.010","DOIUrl":"10.1016/j.amjmed.2024.09.010","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 169-171"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.amjmed.2024.09.028
Ali Saad MD , Eric J. Brandt MD, MHS , Kamil F. Faridi MD, MSc , Jeremy W. Paster PhD , Sohum Sheth BS , Andrew M. Freeman MD , Verity Ramirez MD , Monica Aggarwal MD
Cardiovascular disease is the leading cause of death in the United States. Poor dietary habits are not only a major modifiable risk factor for cardiovascular disease and other chronic illnesses, but they also harm planetary health. Our food system is complex, shaped by agricultural practices and human behaviors. To change it, we need to understand why current agricultural practices exist and address nutrition education, food insecurity, and nutritional security. There are effective ways to make our food system healthier, more equitable, and more sustainable. The best available evidence points to plant-forward diets as the keystone to this complex issue. This manuscript reviews how human and planetary health are connected through our food system and suggests solutions for diets that prevent and treat cardiovascular disease while promoting planetary health.
{"title":"Rethinking Our Roots: The Ground-Up Approach to Heart Health & Planetary Sustainability","authors":"Ali Saad MD , Eric J. Brandt MD, MHS , Kamil F. Faridi MD, MSc , Jeremy W. Paster PhD , Sohum Sheth BS , Andrew M. Freeman MD , Verity Ramirez MD , Monica Aggarwal MD","doi":"10.1016/j.amjmed.2024.09.028","DOIUrl":"10.1016/j.amjmed.2024.09.028","url":null,"abstract":"<div><div>Cardiovascular disease is the leading cause of death in the United States. Poor dietary habits are not only a major modifiable risk factor for cardiovascular disease and other chronic illnesses, but they also harm planetary health. Our food system is complex, shaped by agricultural practices and human behaviors. To change it, we need to understand why current agricultural practices exist and address nutrition education, food insecurity, and nutritional security. There are effective ways to make our food system healthier, more equitable, and more sustainable. The best available evidence points to plant-forward diets as the keystone to this complex issue. This manuscript reviews how human and planetary health are connected through our food system and suggests solutions for diets that prevent and treat cardiovascular disease while promoting planetary health.</div></div>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 196-203"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.amjmed.2024.10.017
Solomon Liao MD , Alpesh N. Amin MD , Steven Barczi MD , Christine Barron MD , Laura E. Degnon CAE , Jennifer G. Duncan MD , Brian Kwan MD , Vera Luther MD , Mary E. Moffatt MD , Angela Myers MD, MPH , Paul O'Rourke Jr. MD, MPH , Iliana D. Vera MBA , Aimee K. Zaas MD, MHS , John Solomonides MD
{"title":"Salary Equity Among Subspecialty Fellows: A Call to Action","authors":"Solomon Liao MD , Alpesh N. Amin MD , Steven Barczi MD , Christine Barron MD , Laura E. Degnon CAE , Jennifer G. Duncan MD , Brian Kwan MD , Vera Luther MD , Mary E. Moffatt MD , Angela Myers MD, MPH , Paul O'Rourke Jr. MD, MPH , Iliana D. Vera MBA , Aimee K. Zaas MD, MHS , John Solomonides MD","doi":"10.1016/j.amjmed.2024.10.017","DOIUrl":"10.1016/j.amjmed.2024.10.017","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 368-371"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.amjmed.2024.03.026
Joseph S. Alpert MD , Mindy Fain MD
{"title":"Frailty: The Sixth and Seventh Ages of Man: Disability and Dementia","authors":"Joseph S. Alpert MD , Mindy Fain MD","doi":"10.1016/j.amjmed.2024.03.026","DOIUrl":"10.1016/j.amjmed.2024.03.026","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 167-168"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension.
Methods
A total of 10,354 Japanese male workers (mean age, 38.4 ± 8.8 years) without hypertension who underwent a baseline annual medical checkup were followed up for three years to detect the development of hypertension. They were divided into six groups according to their smoking status (nonsmokers, new quitters, or continuous smokers) and BW change (≥3 kg or <3 kg) during the follow-up period. Logistic regression analysis was used to calculate odds ratio (OR) for developing hypertension.
Results
During the follow-up period, 1,032 participants developed hypertension. After adjusting for multiple potential confounders, the odds of developing hypertension were significantly higher in new quitters with BW gains ≥ 3 kg (OR, 2.95, 95% confidence interval [CI], 1.37-6.35) compared to nonsmokers with BW gains < 3 kg. However, increased odds of developing hypertension were not observed in those with BW gains < 3 kg (OR, 0.90, 95% CI, 0.52-1.58). Continuous smokers were at increased odds of developing hypertension regardless of their BW changes (BW gain < 3 kg, OR, 1.35, 95% CI, 1.13-1.61 vs. BW gain ≥ 3 kg, OR, 1.90, 95% CI, 1.43-2.52).
Conclusions
The odds of developing hypertension were increased in new quitters only when their BW gain was not controlled after smoking cessation.
{"title":"Smoking Cessation and the Odds of Developing Hypertension in a Working-Age Male Population: The Impact of Body Weight Changes","authors":"Yoshiyuki Saiki MD, PhD , Toshiaki Otsuka MD, PhD , Yasuhiro Nishiyama MD, PhD , Katsuhito Kato MD, PhD , Kuniya Asai MD, PhD , Tomoyuki Kawada MD, PhD","doi":"10.1016/j.amjmed.2024.09.003","DOIUrl":"10.1016/j.amjmed.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension.</div></div><div><h3>Methods</h3><div>A total of 10,354 Japanese male workers (mean age, 38.4 ± 8.8 years) without hypertension who underwent a baseline annual medical checkup were followed up for three years to detect the development of hypertension. They were divided into six groups according to their smoking status (nonsmokers, new quitters, or continuous smokers) and BW change (≥3 kg or <3 kg) during the follow-up period. Logistic regression analysis was used to calculate odds ratio (OR) for developing hypertension.</div></div><div><h3>Results</h3><div>During the follow-up period, 1,032 participants developed hypertension. After adjusting for multiple potential confounders, the odds of developing hypertension were significantly higher in new quitters with BW gains ≥ 3 kg (OR, 2.95, 95% confidence interval [CI], 1.37-6.35) compared to nonsmokers with BW gains < 3 kg. However, increased odds of developing hypertension were not observed in those with BW gains < 3 kg (OR, 0.90, 95% CI, 0.52-1.58). Continuous smokers were at increased odds of developing hypertension regardless of their BW changes (BW gain < 3 kg, OR, 1.35, 95% CI, 1.13-1.61 vs. BW gain ≥ 3 kg, OR, 1.90, 95% CI, 1.43-2.52).</div></div><div><h3>Conclusions</h3><div>The odds of developing hypertension were increased in new quitters only when their BW gain was not controlled after smoking cessation.</div></div>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 245-253.e1"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HIV remains a leading cause of death in the U.S. Previous research has examined mortality patterns among older adults with HIV, revealing regional and demographic disparities. This study aims to assess demographic and regional trends in HIV-related mortality among young adults from 1999 to 2020.
Methods
Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to identify young adults aged 15-44 where HIV was mentioned as either underlying or contributory cause of mortality between 1999 and 2020, using the B20-B24 codes from the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percentage change (APC) were determined.
Results
The AAMRs for HIV in young adults consistently declined from 1999 to 2018, followed by a period of stability from 2018 to 2020 (annual percentage change: 0.5%; 95% confidence interval [95% CI], –7.4 to 9.0), with 64% deaths occurred in medical facilities. Overall, males had a twice AAMR than females (female: 2.22, 95% CI 2.19-2.24; male: 5.19, 95% CI 5.15-5.23). Non-Hispanic (NH) Blacks had sevenfold higher mortality rates than Whites (AAMR 14.88 vs. 2.036). The Southern region experienced threefold higher mortality compared to the Midwest. Metropolitan adults had a twofold higher AAMR than nonmetropolitan adults. States in the top 90th percentile for HIV-related mortality, including Mississippi, Maryland, Florida, Louisiana, and the District of Columbia, exhibited six times higher mortality compared to states in the bottom 10th percentile, such as North Dakota, Idaho, Wyoming, Montana, and Utah.
Conclusions
To address these disparities and ensure continued progress, urgent measures are required.
{"title":"Demographical and Regional Trends of HIV-Related Mortality Among Young Adults in the United States From 1999 to 2020","authors":"Kaneez Fatima MBBS , Amna Siddiqui MBBS , Ghulam Mustafa Ali Malik MBBS , Areeba Farooqui MBBS , Zuha Rasul MBBS , Faba Hanif MBBS , Bisma Mansoor MBBS , Fatima Mansoor MBBS , Mohammad Bilal Abbasi MBBS , Khizar Rehan MBBS , Rahima Azam MBBS , Aaliyan Wajid MBBS , Atida Awan MBBS , Ishaque Hameed MBBS","doi":"10.1016/j.amjmed.2024.09.026","DOIUrl":"10.1016/j.amjmed.2024.09.026","url":null,"abstract":"<div><h3>Background</h3><div>HIV remains a leading cause of death in the U.S. Previous research has examined mortality patterns among older adults with HIV, revealing regional and demographic disparities. This study aims to assess demographic and regional trends in HIV-related mortality among young adults from 1999 to 2020.</div></div><div><h3>Methods</h3><div>Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to identify young adults aged 15-44 where HIV was mentioned as either underlying or contributory cause of mortality between 1999 and 2020, using the B20-B24 codes from the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percentage change (APC) were determined.</div></div><div><h3>Results</h3><div>The AAMRs for HIV in young adults consistently declined from 1999 to 2018, followed by a period of stability from 2018 to 2020 (annual percentage change: 0.5%; 95% confidence interval [95% CI], –7.4 to 9.0), with 64% deaths occurred in medical facilities. Overall, males had a twice AAMR than females (female: 2.22, 95% CI 2.19-2.24; male: 5.19, 95% CI 5.15-5.23). Non-Hispanic (NH) Blacks had sevenfold higher mortality rates than Whites (AAMR 14.88 vs. 2.036). The Southern region experienced threefold higher mortality compared to the Midwest. Metropolitan adults had a twofold higher AAMR than nonmetropolitan adults. States in the top 90th percentile for HIV-related mortality, including Mississippi, Maryland, Florida, Louisiana, and the District of Columbia, exhibited six times higher mortality compared to states in the bottom 10th percentile, such as North Dakota, Idaho, Wyoming, Montana, and Utah.</div></div><div><h3>Conclusions</h3><div>To address these disparities and ensure continued progress, urgent measures are required.</div></div>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"138 2","pages":"Pages 220-227.e5"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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