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 non-ischaemic 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.