Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023)

Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023) Omar Ali Al-Taei, Nuha Al Habsi, Mohammed Al Habsi, Mohamed Al Rawahi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8569123/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Cardiovascular diseases (CVD) remain a leading cause of mortality worldwide, while sudden deaths, encompassing both cardiac and non-cardiac causes, pose substantial public health challenges, particularly in settings with limited surveillance. In Oman, national data on long-term trends in cardiovascular and sudden-death mortality are scarce. Methods We conducted a retrospective, population-based time-trend analysis of national mortality data in Oman from 2014 to 2023 using the Ministry of Health Annual Health Statistical Reports. Cardiovascular deaths were defined according to ICD-10 circulatory system codes, while sudden deaths were defined as unexpected deaths occurring within 24 hours of symptom onset or last being seen alive. Age-standardized mortality rates (ASMRs) were calculated using the WHO world standard population. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC), complemented by Poisson regression models adjusting for population size. Results Over the 10-year period, age-standardized cardiovascular mortality declined substantially, decreasing from 38.49 per 100,000 population in 2014 to 25.71 per 100,000 in 2023 (AAPC − 4.38%, 95% CI − 5.65 to − 3.10). Declines were more pronounced among males (AAPC − 4.87%) than females (AAPC − 2.23%). Notably, females exhibited consistently higher age-standardized cardiovascular mortality than males across much of the study period, with a significant increase observed after 2020. In contrast, sudden death mortality remained high and temporally variable, with ASMRs peaking in 2021 (115.60 per 100,000) before declining in subsequent years. Joinpoint analysis demonstrated a significant increase in sudden death mortality between 2017 and 2021, followed by a significant decline after 2021. In contrast, Poisson regression indicated an overall increasing trend across the entire study period. Conclusions Between 2014 and 2023, Oman achieved meaningful reductions in age-standardized cardiovascular mortality, reflecting progress in cardiovascular prevention and care. However, the persistently high and fluctuating burden of sudden deaths, alongside emerging sex-specific disparities, particularly higher and rising cardiovascular mortality among females, highlights critical gaps in surveillance, prevention, and emergency response. Strengthening national sudden death monitoring, enhancing gender-responsive cardiovascular care, and expanding community-based emergency medical services are essential to further reduce premature mortality and support Oman Vision 2040 health goals. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 01 May, 2026 Reviewers agreed at journal 15 Feb, 2026 Reviews received at journal 15 Feb, 2026 Reviewers agreed at journal 13 Feb, 2026 Reviewers agreed at journal 05 Feb, 2026 Reviewers invited by journal 05 Feb, 2026 Editor invited by journal 13 Jan, 2026 Editor assigned by journal 12 Jan, 2026 Submission checks completed at journal 12 Jan, 2026 First submitted to journal 10 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8569123","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":587479872,"identity":"1244d274-8513-4c4b-8170-d5644fc2fd3b","order_by":0,"name":"Omar Ali Al-Taei","email":"","orcid":"","institution":"Oman Medical Specialty Board","correspondingAuthor":false,"prefix":"","firstName":"Omar","middleName":"Ali","lastName":"Al-Taei","suffix":""},{"id":587479873,"identity":"f58f3057-d0ae-461e-b23d-3e006ac895dc","order_by":1,"name":"Nuha Al Habsi","email":"","orcid":"","institution":"Oman Medical Specialty Board","correspondingAuthor":false,"prefix":"","firstName":"Nuha","middleName":"Al","lastName":"Habsi","suffix":""},{"id":587479874,"identity":"0a590319-427a-4ff1-a8a9-6d3aeae2a911","order_by":2,"name":"Mohammed Al Habsi","email":"","orcid":"","institution":"Sultan Qaboos University","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"Al","lastName":"Habsi","suffix":""},{"id":587479875,"identity":"b848afd4-ff56-431d-8b7c-1cc7c561f002","order_by":3,"name":"Mohamed Al Rawahi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwElEQVRIiWNgGAWjYLACxgYJOQiLjQQtxiRrYUhsIFqL7uzDzyR+7rBIn9+eY8DwoewwA7/YAfxazM6lmUn2npHI3XDmjQHjjHOHGSRnJxDQcobB7AZvG1CLRI4BM2/bYQaD2wS1sH+7+bdNIl1+BlDLX+K08JjdBtqSwHADqIWRSC3lv2XbJAw3nHlWcLDnXDoPEX5h32z4tq1OXr49eeODH2XWcvzSBLQggQSGA0CSh2j1YC2jYBSMglEwCrACABB5QuknkdSQAAAAAElFTkSuQmCC","orcid":"","institution":"Sultan Qaboos University","correspondingAuthor":true,"prefix":"","firstName":"Mohamed","middleName":"Al","lastName":"Rawahi","suffix":""}],"badges":[],"createdAt":"2026-01-10 15:08:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8569123/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8569123/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102297554,"identity":"fc1db6f1-5b35-4a2d-a64c-7569ac1cc8e8","added_by":"auto","created_at":"2026-02-10 10:28:11","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":698222,"visible":true,"origin":"","legend":"","description":"","filename":"TenYearTrendsinCirculatoryandSuddenDeathsinOmanANationalAnalysis20142023.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8569123/v1_covered_f7690307-9263-44ca-8a57-819f264a129b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023)","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8569123/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8569123/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCardiovascular diseases (CVD) remain a leading cause of mortality worldwide, while sudden deaths, encompassing both cardiac and non-cardiac causes, pose substantial public health challenges, particularly in settings with limited surveillance. In Oman, national data on long-term trends in cardiovascular and sudden-death mortality are scarce.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a retrospective, population-based time-trend analysis of national mortality data in Oman from 2014 to 2023 using the Ministry of Health Annual Health Statistical Reports. Cardiovascular deaths were defined according to ICD-10 circulatory system codes, while sudden deaths were defined as unexpected deaths occurring within 24 hours of symptom onset or last being seen alive. Age-standardized mortality rates (ASMRs) were calculated using the WHO world standard population. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC), complemented by Poisson regression models adjusting for population size.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOver the 10-year period, age-standardized cardiovascular mortality declined substantially, decreasing from 38.49 per 100,000 population in 2014 to 25.71 per 100,000 in 2023 (AAPC \u0026minus;\u0026thinsp;4.38%, 95% CI \u0026minus;\u0026thinsp;5.65 to \u0026minus;\u0026thinsp;3.10). Declines were more pronounced among males (AAPC \u0026minus;\u0026thinsp;4.87%) than females (AAPC \u0026minus;\u0026thinsp;2.23%). Notably, females exhibited consistently higher age-standardized cardiovascular mortality than males across much of the study period, with a significant increase observed after 2020. In contrast, sudden death mortality remained high and temporally variable, with ASMRs peaking in 2021 (115.60 per 100,000) before declining in subsequent years. Joinpoint analysis demonstrated a significant increase in sudden death mortality between 2017 and 2021, followed by a significant decline after 2021. In contrast, Poisson regression indicated an overall increasing trend across the entire study period.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eBetween 2014 and 2023, Oman achieved meaningful reductions in age-standardized cardiovascular mortality, reflecting progress in cardiovascular prevention and care. However, the persistently high and fluctuating burden of sudden deaths, alongside emerging sex-specific disparities, particularly higher and rising cardiovascular mortality among females, highlights critical gaps in surveillance, prevention, and emergency response. Strengthening national sudden death monitoring, enhancing gender-responsive cardiovascular care, and expanding community-based emergency medical services are essential to further reduce premature mortality and support Oman Vision 2040 health goals.\u003c/p\u003e","manuscriptTitle":"Ten-Year Trends in Cardiovascular and Sudden Death Mortality in Oman: A National Population-Based Time-Trend Analysis (2014–2023)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-09 17:19:09","doi":"10.21203/rs.3.rs-8569123/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-01T13:30:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263418425614104929053974945366436578025","date":"2026-02-16T00:22:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-15T10:54:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"143766933128840952922159606183845875521","date":"2026-02-13T09:30:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"191832042829744766252752721496290114203","date":"2026-02-05T13:13:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-05T12:53:22+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-13T08:01:19+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-12T09:37:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-12T09:33:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-01-10T15:03:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"16715a25-4f76-4c31-967a-8d8c45ab9f4f","owner":[],"postedDate":"February 9th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-01T13:30:39+00:00","index":65,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T17:19:09+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-09 17:19:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8569123","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8569123","identity":"rs-8569123","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}