Heart Failure Burden Increasing for Black Adults in the U.S.

A new analysis suggests that the total burden of heart failure is increasing, and that disparities between black and white adults persist.

The study researchers, presented at the Heart Failure Society of America and published in the meeting supplement of the Journal of Cardiac Failure, included over 20,000 participants who identified as non-Hispanic black or white from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016. The authors then calculated age-adjusted heart failure prevalence by two-year cycles and used weighted linear regression to evaluate trends over time. The researchers calculated odds ratios and 95% confidence intervals of heart failure in blacks versus whites by “pooling cycles into six-year periods with adjustment for age, sex, cardiovascular risk factors (CV RF), renal function, and proxies of socioeconomic status (education level and health insurance status).” Groups were stratified by age (35-64, and 65+ years).

According to the analysis results, age-adjusted prevalence of heart failure per 100,000 increased among blacks in a linear fashion from 3,921 in 1999-2000 to 6,568 in 2015-2016 (P-trend<0.05). The overall prevalence of heart failure per 100,000 persons remained stable among whites between 1999 and 2016 (P-trend>0.05). The age- and sex-adjusted odds of heart failure in blacks versus whites was higher in two study time periods (2005-2010 and 2011-2016) both before and after adjustment for CV RF and socioeconomic status, driven primarily by differences in heart failure prevalence between younger blacks and whites, according to the study.

“The prevalence of HF in blacks is increasing and the odds of HF was significantly higher in blacks compared to whites,” the researchers concluded. “While the increased odds of HF was attenuated after adjusting for risk factors and socioeconomic status, disparities persisted and have widened over time. Research and resources aimed at identifying social determinants of HF, alongside aggressive management of risk factors, are needed to prevent HF and reduce disparities.”

Rethy L, Thanh-Huyen T, Kershaw K, et al. J Card Fail. 2019;25(85):S10. Abstract 025.