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Introduction While historical declines in cardiovascular disease have been driven by lifestyle improvements and medical advancements, rising obesity and diabetes now present a significant challenge. The impact of various risk factors differs across cardiovascular conditions. This study aimed to examine the secular trends in total events—including incidence, recurrence, and mortality— both overall and by population sub-group, in Greater Glasgow and Clyde, which has the highest cardiovascular mortality rate under 75 years of age in the United Kingdom. This study describes secular trends in cardiovascular events by individual condition from 2012 to 2022.Methods All NHS Greater Glasgow and Clyde residents aged >=51 years in 2012 were included. Sex was defined as sex at birth. Age at baseline was categorised as 51–64. 65–79, and >=80 years. Area deprivation was measured using the 2012 Scottish Index of Multiple Deprivation (SIMD) derived from postcode of residence using aggregated Census data applied to small areas with a mean population of 1,500 people. Linked hospital admission and death data (West of Scotland Safe Haven) were used to ascertain total annual events for ischaemic heart disease (IHD), myocardial infarction (MI), heart failure (HF), atrial fibrillation (AF), stroke, abdominal aortic aneurysm (AAA), and peripheral artery disease (PAD) from 2012–2022 using OPCS-4 procedure codes and ICD-10 codes. Poisson regressions with robust standard errors were used to examine the relative change in event rates over time, overall and by subgroup. Study approval was granted by the NHS GGC Privacy and Advisory Committee (IRAS Project ID 321198, REC reference 22/WS/1063).Results In the cohort of 452,094 Greater Glasgow and Clyde residents aged ≥51 years, 240,616 (53.2%) were women, 221,320 (49.0%) were aged 51–64 years, and 64,155 (14.2%) were aged 80 years or above. The event rate ratios for IHD, MI, AF, and AAA all fell between 2012 and 2021 following adjustment for age, sex, and deprivation ( figure 1). However, on sub-group analysis, the rate ratios increased between 2012 and 2022 among those aged 51–64 years for HF (rate ratios [RR] 1.5), stroke (RR 1.4), and PAD (RR 1.8).Abstract 7-019 Figure 1Cardiovascular disease hospitalisation and mortality rates in NHS GGC residents aged >=51 between 2012 and 2022Conclusions Overall declines in most types of cardiovascular disease mask an increasing burden of cardiovascular events relating to HF, stroke and PAD among individuals aged 51–64 years. The impact of novel cardiovascular therapies, including SGLT2i and GLP1 agonists, on broader long-term population data will be eagerly anticipated.