Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data

Background: Diabetes mellitus is a rapidly growing global health issue, projected to affect 643 million adults by 2030. Atherosclerosis, a prevalent complication of diabetes, significantly contributes to morbidity and mortality among affected individuals. This study aimed to analyze mortality trends...

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Main Authors: Yusuf Hasan Ali, Fakhar Latif, Fatimah Hoda, Azeem Hassan, Huda Ahmed, Raheel Ahmed, Vikash Jaiswal
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Atherosclerosis Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667089525000082
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author Yusuf Hasan Ali
Fakhar Latif
Fatimah Hoda
Azeem Hassan
Huda Ahmed
Raheel Ahmed
Vikash Jaiswal
author_facet Yusuf Hasan Ali
Fakhar Latif
Fatimah Hoda
Azeem Hassan
Huda Ahmed
Raheel Ahmed
Vikash Jaiswal
author_sort Yusuf Hasan Ali
collection DOAJ
description Background: Diabetes mellitus is a rapidly growing global health issue, projected to affect 643 million adults by 2030. Atherosclerosis, a prevalent complication of diabetes, significantly contributes to morbidity and mortality among affected individuals. This study aimed to analyze mortality trends associated with atherosclerosis in diabetic patients aged ≥45 years, with particular focus on variations by sex, race, urban-rural classification, and geographical regions in the US from 1999 to 2020. Methods: We conducted a study using data from the CDC WONDER database, identifying atherosclerosis-related deaths in diabetic patients. We calculated age-adjusted mortality rates (AAMRs) per 100,000 population and analyzed trends over time using Joinpoint regression to assess annual percentage changes (APC) and average annual percentage changes (AAPC). Results: A total of 674,582 atherosclerosis-related deaths were recorded in diabetic patients from 1999 to 2020, with a higher prevalence in men (57.40 %). The majority of deaths occurred in NH White individuals (81.70 %). Overall, AAMRs declined from 32.8 in 1999 to 25.8 in 2020. A significant decrease was observed from 1999 to 2014 (APC: −2.61, p < 0.05), followed by stability (2014–2018) and a subsequent rise (APC: 6.97, p < 0.05) till 2020. Sex-stratified analysis indicated persistently higher AAMRs in men, with a significant increase from 2018 to 2020 (APC: 7.33, p < 0.05). Racial disparities were evident, with NH Black individuals demonstrating the highest AAMRs. Geographic analysis revealed higher AAMRs in nonmetropolitan areas, with notable state-level variations. All census regions exhibited an initial decline, followed by a significant rise in AAMRs post-2018 (p < 0.05). Conclusion: Despite initial declines, recent trends indicate a resurgence in atherosclerosis-related mortality among diabetic patients, particularly in specific racial groups, rural areas, and certain regions. These findings underscore the need for targeted interventions to address disparities and improve cardiovascular outcomes in diabetic populations.
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spelling doaj-art-9a380d8188ca46f1bb6f4db97a3b246a2025-08-20T02:31:09ZengElsevierAtherosclerosis Plus2667-08952025-06-0160273410.1016/j.athplu.2025.04.001Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national dataYusuf Hasan Ali0Fakhar Latif1Fatimah Hoda2Azeem Hassan3Huda Ahmed4Raheel Ahmed5Vikash Jaiswal6Department of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanNational Heart &amp; Lung Institute, Imperial College London, London, UKDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanNational Heart &amp; Lung Institute, Imperial College London, London, UK; Department of Cardiology, Royal Brompton Hospital, London, UK; Corresponding author. National Heart &amp; Lung Institute, Imperial College London, London, UK.Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USABackground: Diabetes mellitus is a rapidly growing global health issue, projected to affect 643 million adults by 2030. Atherosclerosis, a prevalent complication of diabetes, significantly contributes to morbidity and mortality among affected individuals. This study aimed to analyze mortality trends associated with atherosclerosis in diabetic patients aged ≥45 years, with particular focus on variations by sex, race, urban-rural classification, and geographical regions in the US from 1999 to 2020. Methods: We conducted a study using data from the CDC WONDER database, identifying atherosclerosis-related deaths in diabetic patients. We calculated age-adjusted mortality rates (AAMRs) per 100,000 population and analyzed trends over time using Joinpoint regression to assess annual percentage changes (APC) and average annual percentage changes (AAPC). Results: A total of 674,582 atherosclerosis-related deaths were recorded in diabetic patients from 1999 to 2020, with a higher prevalence in men (57.40 %). The majority of deaths occurred in NH White individuals (81.70 %). Overall, AAMRs declined from 32.8 in 1999 to 25.8 in 2020. A significant decrease was observed from 1999 to 2014 (APC: −2.61, p < 0.05), followed by stability (2014–2018) and a subsequent rise (APC: 6.97, p < 0.05) till 2020. Sex-stratified analysis indicated persistently higher AAMRs in men, with a significant increase from 2018 to 2020 (APC: 7.33, p < 0.05). Racial disparities were evident, with NH Black individuals demonstrating the highest AAMRs. Geographic analysis revealed higher AAMRs in nonmetropolitan areas, with notable state-level variations. All census regions exhibited an initial decline, followed by a significant rise in AAMRs post-2018 (p < 0.05). Conclusion: Despite initial declines, recent trends indicate a resurgence in atherosclerosis-related mortality among diabetic patients, particularly in specific racial groups, rural areas, and certain regions. These findings underscore the need for targeted interventions to address disparities and improve cardiovascular outcomes in diabetic populations.http://www.sciencedirect.com/science/article/pii/S2667089525000082AtherosclerosisDiabetes mellitusMortalityUnited StatesCentre for Disease controlWONDER database
spellingShingle Yusuf Hasan Ali
Fakhar Latif
Fatimah Hoda
Azeem Hassan
Huda Ahmed
Raheel Ahmed
Vikash Jaiswal
Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
Atherosclerosis Plus
Atherosclerosis
Diabetes mellitus
Mortality
United States
Centre for Disease control
WONDER database
title Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
title_full Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
title_fullStr Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
title_full_unstemmed Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
title_short Trends of atherosclerosis-related mortality in adults with diabetes: A cross-sectional analysis of U.S. national data
title_sort trends of atherosclerosis related mortality in adults with diabetes a cross sectional analysis of u s national data
topic Atherosclerosis
Diabetes mellitus
Mortality
United States
Centre for Disease control
WONDER database
url http://www.sciencedirect.com/science/article/pii/S2667089525000082
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