Trends and Disparities in Cardiovascular Mortality Among U.S. Adults With and Without Self-Reported Diabetes, 1988-2015 - PubMed (original) (raw)

. 2018 Nov;41(11):2306-2315.

doi: 10.2337/dc18-0831. Epub 2018 Aug 21.

Affiliations

Yiling J Cheng et al. Diabetes Care. 2018 Nov.

Abstract

Objective: Cardiovascular disease (CVD) mortality has declined substantially in the U.S. The aims of this study were to examine trends and demographic disparities in mortality due to CVD and CVD subtypes among adults with and without self-reported diabetes.

Research design and methods: We used the National Health Interview Survey (NHIS) (1985-2014) with mortality follow-up data through the end of 2015 to estimate nationally representative trends and disparities in major CVD, ischemic heart disease (IHD), stroke, heart failure, and arrhythmia mortality among adults ≥20 years of age by diabetes status.

Results: Over a mean follow-up period of 11.8 years from 1988 to 2015 of 677,051 adults, there were significant decreases in major CVD death (all P values <0.05) in adults with and without diabetes except adults 20-54 years of age. Among adults with diabetes, 10-year relative changes in mortality were significant for major CVD (-32.7% [95% CI -37.2, -27.9]), IHD (-40.3% [-44.7, -35.6]), and stroke (-29.2% [-40.0, -16.5]), but not heart failure (-0.5% [-20.7, 24.7]), and arrhythmia (-12.0% [-29.4, 77.5]); the absolute decrease of major CVD among adults with diabetes was higher than among adults without diabetes (P < 0.001). Men with diabetes had larger decreases in CVD death than women with diabetes (P < 0.001).

Conclusions: Major CVD mortality in adults with diabetes has declined, especially in men. Large reductions were observed for IHD and stroke mortality, although heart failure and arrhythmia deaths did not change. All race and education groups benefitted to a similar degree, but significant gaps remained across groups.

© 2018 by the American Diabetes Association.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1—

Figure 1—

Trends in mortality by age-groups and select CVDs among adults with diabetes. Among U.S. adults both with and without diabetes by three age-groups (20–54, 55–65, and ≥65 years of age), the sex- and race/ethnicity-adjusted death rates from major CVD including IHD and stroke have decreased steadily from 1988 to 2015, especially among adults ≥65 years of age with diabetes. The solid lines represent the mortality of adults with diabetes, and the dashed lines represent the mortality of adults without diabetes. The green lines represent the mortality of adults 20–54 years of age, the orange lines represent the mortality of adults 55–65 years of age, and the blue lines represent the mortality of adults ≥65 years of age.

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