Males had higher hypertension and diabetes cardiovascular mortality than females, with sharper increases after 2014; female rates declined then rebounded post-2014.
Does gender affect cardiovascular mortality trends associated with hypertension and diabetes?
Cardiovascular mortality related to hypertension and diabetes has surged since 2014, with males experiencing consistently higher and more rapidly increasing mortality rates than females.
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Abstract Background Hypertension and diabetes are major contributors to cardiovascular mortality, with significant gender disparities in outcomes. This study examines gender-specific trends in cardiovascular mortality associated with these conditions, highlighting differences in mortality rates and temporal patterns over two decades. Purpose This study investigates gender disparities in cardiovascular mortality related to hypertension and diabetes, analyzing trends from 1999 to 2023 to reveal differences in mortality rates, temporal shifts, and overall disease burden by sex. Methods Using CDC WONDER database (1999-2023), cardiovascular mortality trends were analyzed by gender. ICD-10 codes identified cardiovascular deaths (I10-I64) with hypertension (I10-I13) or diabetes (E10-E11) as contributing causes. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 population were calculated. Analysis was conducted using JoinPoint (v5.3) to calculate annual percent change (APC) and average annual percent change (AAPC). Results The study revealed significant gender differences in cardiovascular mortality trends associated with hypertension and diabetes. For hypertension, Females experienced an initial increase (APC: 38.15, 95% CI: 12.71–58.85) until 2001, followed by a decline (APC: -1.51, 95% CI: -4.49 to -0.60) until 2015, after which rates increased again (APC: 4.09, 95% CI: 1.98–8.81). Males showed a similar pattern, with a steeper initial increase (APC: 41.11, 95% CI: 12.39–64.53) until 2001, followed by near stability (APC: 0.03, 95% CI: -5.95 to 1.07) and a subsequent rise after 2014 (APC: 4.34, 95% CI: 2.71–8.40). The overall AAPC was higher in males (4.58, 95% CI: 3.22–5.87) than females (3.19, 95% CI: 1.94–4.36). Mortality rates in females peaked at 50.37 in 2003, declined to 42.85 in 2014, and rose to 56.79 in 2021. Males showed a steady increase from 55.65 in 2000 to 85.58 in 2021. For diabetes, females exhibited a decreasing trend (APC: -3.41, 95% CI: -4.19 to -2.63) until 2014, followed by an increase (APC: 6.22, 95% CI: -5.31 to 10.59). Males also showed an initial decline (APC: -1.84, 95% CI: -2.27 to -1.46) until 2014, with a sharper increase thereafter (APC: 7.32, 95% CI: 6.54–9.70). The overall AAPC was -0.42 (95% CI: -0.78 to -0.01) for females and 0.92 (95% CI: 0.67–1.14) for males. Female rates decreased from 6.48 in 1999 to 3.96 in 2014, then rose to 6.22 in 2021. Male rates declined from 8.58 in 1999 to 6.7 in 2014, peaking at 11.18 in 2021. Conclusion Males had consistently higher cardiovascular mortality rates than females, with steeper increases after 2014 for both hypertension and diabetes. While females showed initial declines, their mortality rates rebounded. Hypertension-related mortality showed fluctuating patterns in both sexes, with males experiencing consistently higher rates. Diabetes-related mortality initially declined but surged after 2014, especially in males.
Sajnani et al. (Sat,) reported a other. Males had higher hypertension and diabetes cardiovascular mortality than females, with sharper increases after 2014; female rates declined then rebounded post-2014.