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一场不断升级的危机:2000年至2023年美国糖尿病和高血压相关死亡率趋势的负担不断加重

A Rising Crisis: Escalating Burden of Diabetes Mellitus and Hypertension-Related Mortality Trends in the United States, 2000-2023.

作者信息

Siddiqui Hibah, Imran Zahra, Ali Dua, Sajid Maryam, Khan Taimor Mohammed, Salim Hussain, Uddin Muhammad Salik, Qureshi Shaheer, Farhan Muzammil, Waqas Saad Ahmed

机构信息

Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Imperial College London, UK.

出版信息

Clin Cardiol. 2025 Jul;48(7):e70167. doi: 10.1002/clc.70167.

Abstract

INTRODUCTION

Diabetes mellitus and hypertension are major contributors to cardiovascular and renal disease mortality, yet their combined long-term impact on mortality trends in the United States remains underexplored. This study evaluates national trends in DM and hypertension-related mortality from 2000 to 2023, analyzing disparities across sex, age groups, race/ethnicity, urbanization, and geographic regions.

METHODS

We analyzed mortality data from the CDC-WONDER database, identifying deaths with DM and hypertension as listed causes among adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, and temporal trends were assessed using Joinpoint regression to determine annual percentage changes.

RESULTS

A total of 2,742,668 DM and hypertension-related deaths were recorded. The AAMR nearly doubled from 33.7 per 100,000 in 2000 to 66.2 per 100,000 in 2023. A sharp increase was observed from 2018 to 2021 (APC: 16.3 [95% CI: 11.8-19.6]), followed by a decline through 2023. Men had consistently higher mortality rates than females. Mortality rates were highest among older adults (65+ years), Non-Hispanic Black individuals, and nonmetropolitan populations. The South had the highest mortality rates, with Mississippi and the District of Columbia reporting the greatest burden.

CONCLUSIONS

DM and hypertension-related mortality has significantly increased over the past two decades, with notable demographic and geographic disparities. Public health interventions should prioritize high-risk populations to mitigate mortality trends and improve health equity.

摘要

引言

糖尿病和高血压是导致心血管疾病和肾脏疾病死亡的主要因素,然而它们对美国死亡率趋势的综合长期影响仍未得到充分研究。本研究评估了2000年至2023年期间糖尿病和高血压相关死亡率的全国趋势,分析了性别、年龄组、种族/族裔、城市化程度和地理区域之间的差异。

方法

我们分析了疾病控制与预防中心(CDC)的WONDER数据库中的死亡率数据,确定25岁及以上成年人中列出的糖尿病和高血压导致的死亡。计算了每10万人的年龄调整死亡率(AAMR),并使用Joinpoint回归评估时间趋势以确定年度百分比变化。

结果

共记录了2742668例糖尿病和高血压相关死亡。年龄调整死亡率从2000年的每10万人33.7例几乎翻了一番,到2023年达到每10万人66.2例。2018年至2021年期间观察到急剧上升(年度百分比变化:16.3 [95%置信区间:11.8 - 19.6]),随后到2023年有所下降。男性的死亡率一直高于女性。死亡率在老年人(65岁及以上)、非西班牙裔黑人以及非都市人口中最高。南部地区的死亡率最高,密西西比州和哥伦比亚特区的负担最重。

结论

在过去二十年中,糖尿病和高血压相关死亡率显著上升,存在明显的人口统计学和地理差异。公共卫生干预应优先考虑高危人群,以缓解死亡率趋势并改善健康公平性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b9e/12217654/13ddfadde393/CLC-48-e70167-g003.jpg

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