Demographic and regional trends in heart failure-related mortality in young adults in the US, 1999-2019
Key points What are the trends in heart failure (HF)-related mortality in young adults? Findings In this cohort study, 61,729 HF-related deaths were identified in young adults between 1999 and 2019, and the overall age-adjusted mortality rate per 100,000 people increased from 2.36 in 1999 to 3.16 in 2019. . Black adults had a 3-fold higher mortality rate compared to white adults, and there were significant sex, race and ethnicity, and geographic variations during the study period. Meaning There is a high burden of HF-related mortality in young adults that is increasing, and health policy measures are needed to address this worrying trend. |
Importance
There are limited data on mortality trends in young adults with heart failure (HF).
Aim
To study trends in HF-related mortality among young adults.
Design, environment and participants
This retrospective cohort analysis used mortality data from young adults aged 15 to 44 years with heart failure listed as a contributing or underlying cause of death in the Centers for Disease Control and Prevention’s Wide Range of Online Data for Epidemiologic Research database. US Disease Control and Prevention from January 1999 to December 2019. Analysis was conducted in October 2021.
Exhibitions
Age 15 to 44 years with FH listed as contributing or underlying cause of death.
Main results and measures
HF-related age-adjusted mortality rates (AAMR) per 100,000 US population stratified by sex, race and ethnicity, and geographic areas.
Results
Between 1999 and 2019, a total of 61,729 HF-related deaths occurred in young adults. Of these, 38,629 (62.0%) were men and 23,460 (38.0%) were women, and 22,156 (35.9%) were black, 6,648 (10.8%) were Hispanic, and 30,145 (48.8%) were white.
The overall age-adjusted mortality (AAMR) per 100,000 people for HF in young adults increased from 2.36 in 1999 to 3.16 in 2019.
FH mortality increased in young men and women, and men had higher AAMRs throughout the study period.
AAMR increased for all racial and ethnic groups, with Black adults having the highest AAMR (6.41 in 1999 and 8.58 in 2019). AAMR for Hispanic adults and white adults increased from 1.62 to 2.04 and from 1.83 to 2.45 over the same time period, respectively.
In most demographic and regional subgroups, HF-related mortality remained stable or decreased between 1999 and 2012,
Conclusions and relevance
After an initial period of stability, HF-related mortality in young adults increased from 2012 to 2019 in the United States. Black adults have 3 times higher AAMR compared to white adults, with significant geographic variation.
Specific health policy measures are needed to address the growing burden of HF in young adults, with a focus on prevention, early diagnosis, and reducing disparities.
