1. In this retrospective cohort analysis, heart failure (HF) related mortality increased in young adults between 1999 and 2019.
2. There are significant demographic trends in HF-related death in young adults; in particular, men were found to have a significantly higher death rate than women, and black adults were found to have a significantly higher death rate than white and Hispanic adults.
Evidence Rating Level: 2 (Good)
Heart failure is usually diagnosed in older adults, but there has been an increase in the number of young adults diagnosed with HF in recent years. This may be related to the increasing burden of cardiometabolic risk factors that start at a younger age. There is limited data on HF-related mortality in younger adults, and it is important to characterize this issue to guide future health policies. This study aims to investigate demographic and regional trends of HF-related mortality in young adults. Data were extracted from the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) from January 1999 to December 2019, and young adults, defined as 15 to 44 years old, with HF as contributing or underlying cause of death were included in the study. The crude death rates were determined by dividing the number of HF-related deaths by the US population for that year, and age-adjusted death rates (AAMR) were calculated by standardizing the HF-related deaths for the 2000 US population. A total of 61729 HF-related deaths occurred in young adults in the United States. With regard to individual groups, the AAMR was significantly higher in males than females (P<.05), and three times higher in black adults compared to Hispanic and white adults (P<.05). Overall, the AAMR for HF in young adults increased over the study duration, for both males and females, as well as across all race and ethnic groups. This increase was that black adults had the highest increase in AAMR, followed by Hispanic and white adults. With regard to geographic trends, states in the top 10e percentile of HF-related deaths had a significantly higher mortality burden than those in the lower 10e percentile. Overall, this study reports an increase in HF-related mortality in young adults in recent years and examines the demographic and regional patterns of this increase. Black adults were reported to have increased AAMR compared to white and Hispanic adults, and significant geographic differences were also reported. It is imperative to characterize patterns of HF-related mortality so that possible contributing factors that result in health care variability can be identified, and so that health policies can be developed to address these discrepancies. In terms of limitations, the increase in the use of electronic health records may contribute to the increase in reported HF-related deaths in recent years. In addition, further characterization of patients’ socioeconomic status and other possible contributing factors would be ideal to identify specific risk factors.
Click to read the study in JAMA Cardiology
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