Dataset Information

Divergent Temporal Trends in Morbidity and Mortality Related to Heart Failure and Atrial Fibrillation: Age, Sex, Race, and Geographic Differences in the United States, 1991-2015.

ABSTRACT: Background Heart failure ( HF ) and atrial fibrillation ( AF ) are rising in prevalence and pose a substantial public health burden. Methods and Results We evaluated temporal trends specific to age, sex, race, and geographic region in rates of HF - and AF -related morbidity, mortality, and years of potential life lost at age 75 years between 1991 and 2015 in the United States. For trends in hospitalization with a primary diagnosis of HF versus AF , we used data for patients aged ?30 years from 1993 to 2014 from the Nationwide Inpatient Sample. For trends in death due to HF versus AF , we used data from 1991 to 2015 from the National Center for Health Statistics. Over the past 25 years, the age-adjusted rates of hospitalization declined for HF (-1.72% per year) but increased for AF (+1.61% per year). HF mortality rates remained unchanged, whereas those for AF increased (+11.2% per year). Years of potential life lost increased for both HF (+0.4% per year) and AF (+9.8% per year). Trends in HF and AF morbidity rates varied moderately by age group, whereas mortality rates varied by age and race. HF and AF hospitalization and mortality rates rose for individuals aged <50 years. HF hospitalization rates declined in all 4 US census regions, whereas AF rates increased. Conclusions We observed divergent trends of decreasing hospitalization and mortality rates for HF versus increasing rates for AF . Variations in disease burden by race and geography warrant specific targeting of "at risk" groups in selected US regions. Additional studies are warranted to evaluate the rising burden of both conditions in younger adults.

SUBMITTER: Vasan RS

PROVIDER: S-EPMC6507208 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Divergent Temporal Trends in Morbidity and Mortality Related to Heart Failure and Atrial Fibrillation: Age, Sex, Race, and Geographic Differences in the United States, 1991-2015.

Vasan Ramachandran S RS Zuo Yi Y Kalesan Bindu B

Journal of the American Heart Association 20190401 8

Background Heart failure ( HF ) and atrial fibrillation ( AF ) are rising in prevalence and pose a substantial public health burden. Methods and Results We evaluated temporal trends specific to age, sex, race, and geographic region in rates of HF - and AF -related morbidity, mortality, and years of potential life lost at age 75 years between 1991 and 2015 in the United States. For trends in hospitalization with a primary diagnosis of HF versus AF , we used data for patients aged ≥30 years from 1 ...[more]

PMID: 30955391

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Project description:ImportanceDisparities by sex and racial/ethnic group in suicide death rates are present in US adolescents. Whether disparities in suicide death extend to groups targeted for suicide prevention efforts, namely, those with suicidal ideation or nonfatal suicide attempts, is unknown.ObjectiveTo examine differences in temporal trends between suicidal ideation and suicide attempts in US adolescents from 1991 through 2019 by sex and race/ethnicity subgroups.Design, setting, and participantsA cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent US adolescents from 1991 to 2019, included 183 563 US high-school students in grades 9 to 12. Data were analyzed from September 16, 2020, through April 12, 2021.ExposuresCalendar year, sex, race/ethnicity, and interactions of sex and race/ethnicity.Main outcomes and measuresSurvey-weighted prevalence estimates, annual percentage changes (APCs) and average APC in the survey-weighted prevalence of suicidal ideation and nonfatal suicide attempts, constructed from self-reported suicidal ideation, plan, and attempts in each survey year, by sex, race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian or Pacific Islander and Native Hawaiian, American Indian/Alaska Native), and their interactions (sex × race/ethnicity).ResultsIn 183 563 (unweighted) included adolescents (mean [SD] age, 16.07 [1.23] years; 94 282 females [weighted percentage, 49.4%; 95% CI, 48.8%-50.1%]), the prevalence of suicidal ideation decreased from 1991 to 2019 (from 19.4% to 15.8%; 95% CI, 0.7%-0.9%), whereas the prevalence of nonfatal suicide attempts increased from 1991 to 2019 (from 7.3% to 8.9%; 95% CI, 1.0%-1.4%). Joinpoint regression indicated a -3.1% (95% CI, -3.7% to -2.6%) annual decrease in suicidal ideation between 1991 and 2009, followed by a 3.4% annual increase (95% CI, 1.9% -4.8%) between 2009 and 2019. Decreasing followed by increasing trends in suicidal ideation showed modestly different turning points in female (1991-2009, 2009-2019), White (1991-2009, 2009-2019), Hispanic (1991-2007, 2007-2019), and Black (1991-2005, 2005-2019) adolescents. Although no significant trends were observed in suicide attempts from 1991 through 2019, male (68.4% increase; 95% CI, 0.2% -1.2%) and Black (79.7% increase; 95% CI, 0.1%-1.5%) adolescents had greater increases in the prevalence of suicide attempts. Interaction of sex and race/ethnicity revealed increases in suicidal ideation in White females from 2009 to 2019 (APC, 4.3%; 95% CI, 1.5%-7.1%), Black females from 2005 to 2019 (APC, 3.4%; 95% CI, 1.4%-5.4%), and Hispanic females from 2009 to 2019 (APC, 3.3%; 95% CI, 1.0%-5.6%) and suicide attempts in White females from 2009 to 2019 (APC, 3.1%; 95% CI, 0.3%-6.0%).Conclusions and relevanceThe findings of this study show apparent sex and racial/ethnic differences in trends in suicidal ideation and suicide attempts. Increases in suicidal ideation since 2009 were observed in female individuals; changes in male and Black adolescents represented the largest increase in the prevalence of suicide attempts between 1991 and 2019. Evidence-based suicide prevention programs need to be tailored by sex and race/ethnicity, calling for greater diversification of health care system, school, and community prevention approaches.

Project description:BackgroundPulse pressure (PP) and mean arterial pressure (MAP) are well-established markers of cardiovascular risk. In this study, we aimed to assess the temporal trend and associated factors of PP and MAP in Chinese children and adolescents.MethodsFrom the China Health and Nutrition Survey 1991-2015, a total of 11,123 children and adolescents aged 7-17 years were included. Stratified analyses and generalized estimating equation (GEE) were conducted to compare the trends of PP and MAP by age and sex over two decades, along with the calculation of average relative increase (ARI). Moreover, multivariable linear regression was used to estimate the associated factors of PP and MAP.ResultsDuring 1991-2015, upward trends were observed in both PP and MAP levels, with ARI of 0.30 and 0.34%, respectively. PP was higher in boys [PP1991 33.9 mmHg (95%CI, 33.40-34.33) to PP2015 35.4 mmHg (34.74-36.15)] than in girls [PP1991 33.3 mmHg (32.83-33.72) to PP2015 34.3 mmHg (33.59-34.99)]. PP was also higher in participants aged 13-17 years [PP1991 36.1 mmHg (35.63-36.62) to PP2015 38.3 mmHg (37.35-39.21)] than in those aged 7-12 years [PP1991 31.5 mmHg (31.09-31.88) to PP2015 33.7 mmHg (33.16-34.30)]. Similar results were found in MAP. Participants with high economic status, general obesity and central obesity, were more likely to have wider PP (β higheconomicstatus = 0.60, 95% CI, 0.19-1.02; β generalobesity = 1.38, 0.87-1.89; β centralobesity = 1.34, 0.70-1.97; all P-values < 0.001) and higher MAP (β higheconomicstatus = 0.82, 0.38-1.26; β generalobesity = 2.88, 2.33-3.42; β centralobesity = 3.14, 2.47-3.80; all P-values < 0.001). Body mass index (BMI) and waist circumference (WC) were positively correlated with PP (β BMI = 0.18, 0.13-0.24; β WC = 0.10, 0.08-0.12; both P-values < 0.001) and MAP (β BMI = 0.43, 0.37-0.49; β WC = 0.20, 0.18-0.22; both P-values < 0.001). In addition, rural setting and glucose level were positively associated with PP (both P < 0.05), while north region residency, uric acid, and total cholesterol were found to be positively associated with MAP (all P < 0.05).ConclusionPP and MAP levels have been increasing dramatically in Chinese children and adolescents over the last two decades. Age, sex, economic status, geographic factors, anthropometric and cardiometabolic factor were positively associated with PP and MAP in pediatric population.

Dataset Information

Divergent Temporal Trends in Morbidity and Mortality Related to Heart Failure and Atrial Fibrillation: Age, Sex, Race, and Geographic Differences in the United States, 1991-2015.

Publications

Divergent Temporal Trends in Morbidity and Mortality Related to Heart Failure and Atrial Fibrillation: Age, Sex, Race, and Geographic Differences in the United States, 1991-2015.

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