Heart failure deaths on the rise among young adults

A study tracking heart failure-related mortality in young adults from 1999 to 2019 found that, after an initial period of stability until 2012, there was a rapid increase that was consistent across all sex, racial, and ethnic groups.[1]

Over the two decades included in the study, which was published in JAMA Cardiology, heart failure-related mortality per 100,000 people rose from 2.36 in 1999 to 3.16 in 2019. 

According to lead author Jain Vardhman, MD, and coauthors, the increase is likely related to two elements: an increase in cardiovascular risk factors among the population in question and more complete reporting of heart failure on death certificates due to the Hospital Readmission Reduction Program and increased electronic health record diagnoses. 

Still, the rise is significant enough for the study’s authors to call for closer examination of health policies to address what they called a “concerning trend.”

“Although declines in cardiovascular mortality between the 1970s to 2010s could signal success of targeted health policy interventions, use of guideline-directed medical therapy, and better mitigation of clinical risk, these data from recent years suggest challenges with the continued successful implementation of these strategies,” the authors wrote. 

Additionally, while mortality numbers rose at similar rates across different racial groups, significant gaps in those rates were consistent throughout the entire time period. Of the 61,729 people who died from heart failure-related causes over the 20-year period observed, 35.9% were Black, 10.8% were Hispanic, and 48.8% were white. The age-adjusted mortality rate for Black adults was 8.58 in 2019, compared with 2.04 for Hispanics and 2.45 for whites. 

There were also significant differences in heart failure mortality rates between people from different regions, with the six states in the upper 90th percentile for heart failure-related mortality—Oklahoma, South Carolina, Louisiana, Arkansas, Alabama, and Mississippi—having significantly higher mortality rates than states in the bottom tenth percentile.

“Targeted health policy measures are needed to address the rising burden of HF in young adults, with a focus on prevention, early diagnosis, and reduction in disparities,” the authors conclude.
 

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