Analyzing trends in multimorbidity-related mortality among patients with lung cancer and hypertensive diseases: A 25-year nationwide analysis.

Abstract

e20694 Background: Multimorbidity, defined as the coexistence of two or more chronic conditions, poses major challenges to healthcare systems globally. Hypertension is a critical comorbidity in lung cancer patients contributing to cardiovascular complications through shared risk factors and treatment-related cardiotoxicity. Despite its clinical significance, temporal trends and demographic disparities in multimorbidity-related mortality among this population remain inadequately characterized. This study aims to identify patterns and correlations to guide healthcare interventions and policies and investigates trends in multimorbidity-related mortality among US patients with lung cancer and hypertensive diseases over two decades. Methods: We conducted a retrospective analysis using CDC WONDER database (1999-2023), including adults ≥25 years with hypertensive diseases (ICD-10: I10-I15) and lung cancer (C34) as causes of death. Age-adjusted mortality rates (AAMR) per 100,000 were calculated. Joinpoint regression identified trends via annual percentage change (APC) and average annual percentage change (AAPC). Results were stratified by sex, age, race/ethnicity, region, and urbanization. Results: From 1999-2023, 274,959 hypertension diseases-related deaths occurred among lung cancer patients. AAMR increased from 2.60 (95% CI: 2.52-2.67) to 6.03 (95% CI: 5.94-6.12), a 131.9% increase, with overall AAPC of 3.31% (95% CI: 2.26-4.37, p < 0.001). Joinpoint analysis identified: acceleration 1999-2001 (APC: 19.53%), increase 2001-2008 (APC: 3.74%), stabilization 2008-2018 (APC: -0.85%), resurgence 2018-2021 (APC: 9.20%), and plateau 2021-2023 (APC: -0.53%). Males had higher AAMRs (5.97 vs 3.92), but females showed steeper increases (AAPC: 3.52% vs 3.02%). Adults ≥65 years had highest AAPC (3.47%). White individuals had highest AAPC (3.91%), followed by Hispanic (3.75%), Black (1.29%), and Asian/PI (1.28%). The South exhibited highest regional AAPC (4.99%), followed by Midwest (2.65%) and Northeast (2.29%). Non-metropolitan areas exceeded metropolitan (AAPC: 4.76% vs 3.10%). Oklahoma (AAMR: 24.55), Mississippi (20.69), South Carolina (16.42) had highest state rates and Utah (1.40) has the lowest. Conclusions: This analysis demonstrates a nearly three-fold increase in multimorbidity-related mortality among lung cancer and hypertensive diseases patients over 25 years, with females, White populations, Southern states, and non-metropolitan areas showing pronounced increases. These findings emphasize the need for integrated cardio-oncology protocols and targeted interventions addressing geographic and demographic disparities.Targeted healthcare strategies are essential to address the specific needs of high-risk populations and ensure equitable access to healthcare resources.