Heart Failure Mortality is Increasing Among Young Adults in the US

The rate of cardiovascular disease (CVD) and heart failure (HF) is on the rise in the US, specifically among adults ages 34 to 65, according to researchers who published their findings in the Journal of the American College of Cardiology.

CVD mortality dropped significantly in the US beginning during the first decade of the 21st century and continued a downward trend until 1970. However, that mortality rate decline began to slow in 2011, combined with a simultaneous increase in HF incidence, which is projected to grow due the augmented prevalence of obesity and diabetes as well as the effects of aging.

In this study, the researchers sought to evaluate national trends in HF-related CVD as it pertains to race and age by acquiring mortality rates from multiple cause of death files using the CDC’s Wide-Ranging Online Data for Epidemiologic Research. This vast database comprises the underlying and contributing causes of mortality from all death certificates in the US. Among both white and black males, 35 to 64, researchers identified HF-related CVD deaths as any death where HF was listed as the underlying cause and CVD as a contributing factor. Also, using the 2000 US Census as the default population, the researchers calculated age-adjusted mortality using weighted averages.

Mortality Increase in Younger Population

According to the results of the study, age-adjusted HF-related CVD declined from 1999 through 2012 (78.7 [95% CI, 78.2 to 78.2] compared to 53.7 [95% CI, 53.3 to 54.1] per 100,000; P<0.05). However, those declining rates shifted, with results indicating an increase in mortality through 2017 (59.3 [95% CI, 58.9 to 59.6] per 100,000; P<0.05). Between blacks and whites, researchers discerned similar patterns of HF-related CVD mortality up until a spike occurred in 2011-2012. Moreover, the study found that black males incurred a 1.16-fold versus 1.43-fold higher risk of age-adjusted HF-related CVD death juxtaposed to white men, while black women had a 1.35-fold versus 1.54-fold higher aged-adjusted HF-related CVD mortality rate compared to white women in 1999 versus 2017 (P<0.05). These data suggest the mortality rates were more notable among younger adults compared to older adults (65 to 84 years old).

A Public Health Issue

The research findings display “that greater loss of life from heart failure is occurring, especially premature death in those under the age of 65,” according to Dr. Sadiya Khan, an assistant professor of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago, who was first author of the paper, in a CNN-published article about the study.

“It’s a shame, because we have better therapeutics than we’ve ever had before for heart failure,” said Dr. Eric Adler, cardiologist and professor of medicine at the University of California, San Diego, was quoted as saying in the article.

Dr. Adler added that [physicians] now have “better medicines, better surgeries and mechanical devices that support the failing heart,” and that he was discouraged “from the standpoint of someone that focuses on HF to see that despite our best efforts and new technologies.”

“We’re seeing an increase in the prevalence and morbidity associated with HF,” Dr. Adler urged. “Why is that the case? I think it’s largely public health issues.”