Trends in Cardiovascular Deaths for US Adults With and Without Diabetes

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Although adults with diabetes have experienced a large overall reduction in the risk for cardiovascular disease mortality, diabetes still increases the risk for mortality.
Although adults with diabetes have experienced a large overall reduction in the risk for cardiovascular disease mortality, diabetes still increases the risk for mortality.

For adults with diabetes, large reductions in ischemic heart disease and stroke mortality were observed between 1988 and 2015, whereas deaths due to arrhythmia and heart failure did not change, according to a study published in Diabetes Care.

Study investigators used data from the National Health Interview Survey (1985 to 2014) and follow-up mortality data through 2015 to estimate trends and disparities in major cardiovascular disease, ischemic heart disease, heart failure, stroke, and arrhythmia mortality for 677,051 adults with diabetes, aged 20 and older.

From 1988 to 2015, significant decreases were found in all major cardiovascular disease mortality for adults with and without diabetes (P <.05 for all), except among adults aged 20 to 54. 

For adults with diabetes, significant 10-year relative mortality changes were seen for major cardiovascular disease (-32.7%; 95% CI, -37.2 to -27.9), stroke (-29.2%; 95% CI, -40.0 to -16.5), and ischemic heart disease (-40.3%; 95% CI, -44.7 to -35.6), but not for arrhythmia (12.0%; 95% CI, -29.4-77.5) and heart failure (-0.5%; 95% CI, -20.7-24.7). Men showed greater decreases in cardiovascular disease mortality than women (P <.001).

Study investigators concluded that although adults with diabetes have experienced a larger overall reduction in the risk for cardiovascular disease mortality than adults without the disease, diabetes still increases the risk for mortality. Furthermore, the researchers stated, "Disparities in [cardiovascular disease] mortality among adults with diabetes have substantially narrowed, especially between women and men, which suggests that mortality and disparities can be reduced by primary prevention of risk factor exposure, and improvements in detection and treatment at individual, community, health care system, and environmental levels."

Reference

Cheng YJ, Imperatore G, Geiss LS, et al. Trends and disparities in cardiovascular mortality among U.S. adults with and without self-reported diabetes mellitus, 1988-2015 [published online August 21, 2018]. Diabetes Care. doi: 10.2337/dc18-0831

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