Trends and Disparities in Diabetes Mellitus and Atrial fibrillation Related Mortality in the United States: 1999-2020

Abstract

The co-occurrence of diabetes mellitus (DM) and atrial fibrillation (AF) poses growing health risks in the United States (U.S.), with diabetes patients having a 34 % higher risk of AF. This study examines trends in DM and AF related mortality among individuals aged ≥ 25 years in the U.S. from 1999 to 2020. Data from the CDC WONDER database were analyzed calculating age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC), stratified by age, sex, race/ethnicity, urbanization, and region. Between 1999 and 2020, 419,036 deaths were recorded among U.S. adults (≥25 years) with comorbid AF and DM. The AAMR rose from 4.83 in 1999 to 15.91 in 2020, with an APC increase of 15.01 from 2018 to 2020. Older adults (≥65) had higher AAMRs than younger adults (25-64). Men (11.23) had higher rates than women (7.16). NH American Indian/Alaskan Natives (9.54) and Whites (9.16) had the highest AAMRs, while NH Asian/Pacific Islanders (6.04) had the lowest. Non-metropolitan areas (10.32) exceeded metropolitan areas (8.53). The Western U.S. (9.87) had the highest regional AAMR. Rising DM and AF-related deaths highlight a growing burden, particularly in men, NH American Indian/Alaskan Natives and Whites, and rural populations, necessitating targeted interventions.

Keywords: Atrial fibrillation; CDC WONDER; Diabetes; Diabetes mellitus; Health disparities; Mortality; Trends; Type 2 diabetes mellitus.