Trends in circulatory system disease hospitalizations in England and Wales: A 21-year secular-trend analysis.

Cardiovascular diseases (CVDs) are the primary reason for mortality worldwide. Patients with CVD were at higher risk of drug-related adverse events and functional impairment and were more likely to be admitted to the hospital. This study aims to study trends for CVD hospital admission (HA) in England and Wales during the past 21 years. A secular-trend analysis study design was utilized to explore the trend of CVD HAs. Poisson regression was used to examine the trend in HAs. To determine trends in admission rates over time, we implemented Joinpoint regression analysis. The permutation test was employed to determine the optimal number of Joinpoints, with the Bayesian information criterion being the basis for model selection, and robust standard errors were calculated to account for overdispersion. During the study period, CVD HAs increased 24.8%, although Joinpoint regression showed different patterns by disease category, age, and gender. Acute rheumatic fever declined in females (annual percent change [APC] = -7.3%) and children under 15 (APC = -4.49%) from 1999 to 2010, but increased after 2010. From 2005 to 2009, chronic rheumatic heart disease grew significantly in both sexes (APC ≈ 18%-20%) and gradually in those aged ≥75 (average annual percent change [AAPC] = 8.60%). Hypertensive diseases fluctuated, with spikes (1999-2010, APC = 8.90%), falls (2010-2013, APC ≈ -31% to -36%), and subsequent increases (APC ≈ 13%-14%). Significantly, pulmonary heart disease, circulation illnesses, and other heart and vascular diseases increased across all age groups (APCs = 5.32%-9.40%), particularly among those aged ≥75 (AAPC = 4.78%). Although ischemic heart disease declined with age (AAPC = -1.72% to -2.51%), cerebrovascular disease showed mixed trends, rising early and late but decreasing after 2009 in those ≥75 years. APCs exhibited short-term surges and dips within intervals, while AAPCs indicated long-term increases for pulmonary and hypertensive illnesses (mainly in younger adults) but declines for ischemic heart disease and cerebrovascular disease in older adults. In England and Wales, HAs owing to CVD have increased during the last 2 decades. Prevention programs for CVD are needed to improve public awareness about this common and serious group of diseases. The focus should be on reducing the prevalence of modifiable risk factors for these diseases.