Trends in Age-Adjusted Cardiovascular Mortality Rates Among the Diabetic Population of the United States: 1999-2020,...

This study examines trends in cardiovascular disease (CVD)-related mortality among individuals with diabetes mellitus (DM) in the United States from 1999 to 2020, focusing on age-adjusted mortality rates (AAMRs) across demographic and geographic subgroups.

Using the CDC WONDER database, we analyzed death certificate data and calculated AAMRs standardized to the 2000 US population. Joinpoint regression was used to analyze annual percentage changes (APCs) in AAMRs by sex, race/ethnicity, and geographic region. Statistical significance was determined at p < 0.05.

From 1999 to 2020, 1,854,384 deaths were attributed to circulatory disorders and DM, with an average AAMR of 25.1%. AAMRs showed a steady decline from 1999 (31.3/100,000) to 2014 (21.9/100,000), followed by an increase to 25.6/100,000 in 2020. Gender analysis revealed significant declines in AAMRs for both males and females, though the rate of decline slowed after 2012. Racial disparities were evident: non-Hispanic Whites and Asian or Pacific Islanders experienced reversals in mortality trends after earlier declines, while Hispanic or Latino groups exhibited a steep rise in AAMRs from 2016 to 2020 (APC = 10.84%). Geographic analysis highlighted considerable variation in mortality rates across states, with Oklahoma reporting the highest AAMR (59.3/100,000).

While overall CVD mortality in individuals with DM has improved, recent increases in AAMRs and persistent demographic and geographic disparities underscore the need for targeted public health strategies. Addressing these disparities is critical to sustaining progress and improving outcomes for vulnerable populations.