Deaths related to heart failure (HF) are becoming more and more common in the United States, according to a new study published in JACC: Heart Failure.[1] This finding sparked researchers to dig deeper and see which patient populations were being impacted the most.
“Previous data suggest that HF mortality has demographic and regional variation, related to the varying prevalence of socioeconomic (eg, poverty) and cardiometabolic (eg, diabetes and obesity) risk factors,” wrote first author Tariq Jamal Siddiqi, MD, of the department of medicine at the University of Mississippi Medical Center in Jackson, Mississippi, and colleagues. “Identifying demographic and regional distribution of HF-related mortality can help identify populations at highest risk so that timely targeted interventions can be provided.”
Siddiqui et al. examined Centers for Disease Control and prevention (CDC) data from 1999 to 2019, focusing on HF-related mortality among adults 75 years old and older. They then tracked the age-adjusted mortality rate (AAMR) per 10,000 persons for each year, demographic group and geographic region in the United States.
The group’s analysis included data from more than 5 million patients. The overall AAMR for the United States dropped from 141 per 10,000 persons in 1999 to 108.3 in 2012. By 2019, the overall AAMR had jumped back up to 121.3 per 10,000 persons.
“In contrast to other diseases in which the mortality rates have recently stabilized or even decreased, we noticed an increase in HF-related mortality among older adults after 2012,” the authors wrote. “This is consistent with patterns observed in HF-related mortality among younger adults since 2012 as well. Reasons for this are multifactorial and may be attributed to recent cutbacks in the healthcare system, such as the hospital readmissions reduction program under which hospitals are financially penalized if they have higher than expected risk-standardized 30-day readmission rates for HF, and rise in comorbidities such as obesity, diabetes, and chronic kidney disease, which are directly associated with higher risk of developing HF in the already increasing older population in the United States.”
Non-Hispanic white adults had a higher AARM (127.2 per 10,000 persons) than any other racial/ethnic group included in the study. Also, men consistently had a higher AAMR (158.3 per 10,000 persons) than women (131).
In addition, Siddiqui and colleagues noted that the Midwest had the highest AAMR (133.9 per 10,000 persons), followed by the South (119.2), West and Northeast (113.5). More rural parts of the country also had a higher AAMR (147 per 10,000 persons) than metropolitan areas (115.2). These differences could be linked to multiple factors, the authors wrote, including the ongoing physician shortage, the influence of specific state policies, limited access to high-quality care and a “poor sedentary lifestyle.”
“Our results underscore the need to conduct large population-based studies in these regions, in an effort to identify primary factors that may contribute to the observed disparity,” the authors wrote.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.