Incidence trends in ischaemic and non-ischaemic heart failure in people with and without type 2 diabetes, 2000-2019: An observational study in England

Aim: To investigate trends in ischaemic and non-ischaemic heart failure (HF) in adults with type 2 diabetes and without diabetes between 1st January 2000 and 31st December 2019 in England. Methods: We used the Clinical Practice Research Datalink datasets, linked to the Hospital Episode Statistics and Office for National Statistics, to estimate sex-specific crude and age-standardised rates of incident ischaemic and non-ischaemic HF up to 10 years per calendar year of diabetes diagnosis and diabetes status. Results: In a cohort of 735,810 individuals, 5,073 ischaemic (2,038 in people with type 2 diabetes and 3,035 in those without) and 16,501 non-ischaemic (6,358 and 10,143, respectively) HF events were recorded during a median follow-up of 10 years. From 2000 to 2004 to 2005-2009, the age-standardised rates of ischaemic HF marginally declined, while rates remained stable for non-ischaemic HF and were consistently higher for nonischaemic than ischaemic HF, regardless of diabetes status or sex. Adjusted incidence rate ratios demonstrated negligible impact on trends after accounting for differences in demographics, comorbidities and medications. Conclusions: Improving HF prevention and management strategies remains crucial to decrease the risk of HF in the general population and reduce the persistent risk-gap associated with type 2 diabetes in England.