Diabetes status was evaluated for its association with time trends in mortality from heart failure and atherosclerotic cardiovascular disease, though specific results are absent in the abstract.
Declines in heart failure mortality have lagged behind improvements in CHD and cerebrovascular mortality, particularly in people with diabetes, highlighting a need for targeted heart failure interventions.
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SummaryBackgroundContemporary trends in cardiovascular disease (CVD) cause-specific mortality by diabetes status are inadequately described. We examined trends by diabetes status in coronary heart disease (CHD), cerebrovascular disease, and heart failure mortality, and mortality rate ratios (people with diabetes versus those without diabetes) across nine high-income jurisdictions.MethodsWe assembled CVD cause-specific mortality data from nine administrative datasets (Europe n=5, Australia n=1, Canada n=2, and South Korea n=1), spanning 2000–23. Using Poisson regression, we estimated mortality rates by diabetes status and mortality rate ratios.FindingsThere were 2·92 million CVD deaths over 1·30 billion person-years of follow-up. In all jurisdictions and in both people with and without diabetes, the total CVD and CHD mortality rates fell across the observed time period. The 5-year percent changes in CHD mortality ranged from −11·5% to −32·3%. Reductions in heart failure mortality were smaller than those for CHD mortality (except in Scotland) and smaller than those for cerebrovascular mortality (except in Scotland and Denmark). Heart failure mortality increased in Ontario, Canada. The excess CHD mortality associated with diabetes (mortality rate ratio ~2·0) fell in three of nine jurisdictions and was stable or uncertain in the remainder. No jurisdiction had a fall in excess heart failure mortality associated with diabetes.InterpretationDeclines in heart failure mortality in both people with and without diabetes were less marked than were declines in CHD and cerebrovascular disease mortality in most jurisdictions. Heart failure mortality rate ratios have not decreased. A greater focus on reducing heart failure mortality in people with and without diabetes might be required.FundingUS Centers for Disease Control and Prevention, Diabetes Australia Research Program, Victoria State Government Operational Infrastructure Support Program.
Gong et al. (Sat,) reported a other. Diabetes status was evaluated for its association with time trends in mortality from heart failure and atherosclerotic cardiovascular disease, though specific results are absent in the abstract.