OBJECTIVE Reductions in heart attack and stroke hospitalizations are well documented in the U.S. population with diabetes. We extended trend analyses to other cardiovascular disease (CVD) conditions, including stroke by type, and used four additional years of data.

RESEARCH DESIGN AND METHODS Using 1998–2014 National (Nationwide) Inpatient Sample (NIS) data, we estimated the number of discharges having acute coronary syndrome (ACS) (ICD-9 codes 410–411), cardiac dysrhythmia (427), heart failure (428), hemorrhagic stroke (430–432), or ischemic stroke (433.x1, 434, and 436) as first-listed diagnosis and diabetes (250) as secondary diagnosis. Hospitalization rates for adults aged ≥35 years were calculated using estimates from the population with and the population without diabetes from the National Health Interview Survey (NHIS) and age-adjusted to the 2000 U.S. standard population. Joinpoint regression was used to analyze trends and calculate an average annual percentage change (AAPC) with 95% confidence limits (CLs).

RESULTS From 1998 to 2014, in the population with diabetes, age-adjusted hospitalization rates declined significantly for ACS (AAPC −4.6% per year [95% CL −5.3, −3.8]), cardiac dysrhythmia (−0.7% [−1.1, −0.2]), heart failure (−3.6% [−4.6, −2.7]), hemorrhagic stroke (−1.1% [−1.4, −0.7]), and ischemic stroke (−2.9% [−3.9, −1.8]). In the population without diabetes, rates also declined significantly for these conditions, with the exception of dysrhythmia. By 2014, rates in the population with diabetes population remained two to four times as high as those for the population without diabetes, with the largest difference in heart failure rates.

CONCLUSIONS CVD hospitalization rates declined significantly in both the population with diabetes and the population without diabetes. This may be due to several factors, including new or more aggressive treatments and reductions in CVD risk factors and CVD incidence.

目标美国糖尿病患者中心脏病发作和中风住院人数的减少已有充分记录。我们将趋势分析扩展到其他心血管疾病 (CVD) 疾病，包括按类型划分的中风，并使用了另外四年的数据。

研究设计和方法使用 1998-2014 年国家（全国）住院患者样本 (NIS) 数据，我们估计了患有急性冠状动脉综合征 (ACS)（ICD-9 代码 410-411）、心律失常 (427)、心力衰竭的出院人数(428)、出血性中风 (430-432) 或缺血性中风 (433.x1、434 和 436) 作为首要诊断，糖尿病 (250) 作为次要诊断。 ≥35 岁成年人的住院率是根据国家健康访问调查 (NHIS) 中患有糖尿病和未患糖尿病的人口的估计值计算的，并根据 2000 年美国标准人口进行了年龄调整。连接点回归用于分析趋势并计算平均年度百分比变化 (AAPC)，置信限 (CL) 为 95%。

结果从 1998 年到 2014 年，在糖尿病人群中，年龄调整后的 ACS 住院率显着下降（每年 AAPC -4.6% [95% CL -5.3, -3.8]）、心律失常（-0.7% [-1.1, -3.8]） -0.2]）、心力衰竭（-3.6% [-4.6, -2.7]）、出血性中风（-1.1% [-1.4, -0.7]）和缺血性中风（-2.9% [-3.9, -1.8]） 。在没有糖尿病的人群中，除心律失常之外，这些疾病的发病率也显着下降。到 2014 年，糖尿病人群的发病率仍然是非糖尿病人群的两到四倍，其中心力衰竭发病率差异最大。

结论糖尿病患者和非糖尿病患者的 CVD 住院率均显着下降。这可能是由于多种因素造成的，包括新的或更积极的治疗方法以及 CVD 危险因素和 CVD 发病率的减少。