On May 3, 2024, Americans are experiencing a higher rate of death due to heart failure compared to 1999, undoing years of progress in reducing mortality rates.
A recent study published in JAMA Cardiology reveals that the current mortality rate from heart failure is 3% higher than it was 25 years ago. Data from death certificates shows a significant decline in mortality from 1999 to 2009, followed by a plateau and then a sharp increase from 2012 to 2019. The pandemic years of 2020 and 2021 saw a further acceleration in heart failure deaths.
Veronique Roger, MD, MPH, from the National Heart, Lung, and Blood Institute, emphasized the urgent need to reverse this trend, noting that the mortality rate from cardiovascular disease had declined during the 2000s but has now stagnated, primarily due to an increase in heart failure deaths.
According to the National Institutes of Health, approximately 6.7 million Americans currently suffer from heart failure, with about 1 in 4 Americans likely to develop the condition in their lifetime. Around half of those diagnosed with heart failure die within 5 years.
While individuals aged 65 or older face a higher risk of death from heart failure, the study found a significant increase in death rates among younger Americans, especially those under 45 and in the 45-64 age group.
Factors Contributing to Heart Failure
The rise in heart failure deaths among younger individuals is believed to be linked to the increasing prevalence of obesity and diabetes in this age group, leading to the development of heart failure in middle age, according to study co-author Marat Fudim, MD.
The surge in heart failure mortality rates affected all demographics similarly, with comorbidities playing a significant role in driving heart failure, according to Fudim. The COVID-19 pandemic accelerated the trend of increasing deaths from heart failure.
There was a notable increase in mortality rates among patients hospitalized for COVID-related pneumonia, leading to a higher chance of developing heart failure. COVID also exacerbated existing health disparities and shifted healthcare focus away from heart failure prevention and management.
Key Factors in Rising Mortality Rates
Sadiya S. Khan, MD, a professor at Northwestern University, highlighted the impact of comorbidities, particularly kidney disease, on heart failure deaths, noting an earlier onset of heart failure in individuals with such disorders.
Khan’s research suggested that advancements in treating underlying heart diseases like ischemic heart disease have contributed to declining mortality rates for heart disease, contrasting with the rising trend in heart failure deaths.
The lack of progress in developing effective therapies for heart failure compared to other cardiovascular diseases has been attributed to the surge in heart failure mortality rates. Additionally, the prevalence of heart failure and the worsening health status of patients may have also contributed to the increased death rate.
Identifying the Root Causes
Was it the prevalence of heart failure or the severity of the condition that led to higher mortality rates? Research indicates that despite efforts in treating heart failure, concerns around obesity and diabetes remain significant drivers of this trend.
According to Roger, the healthcare system’s limitations in providing adequate care, especially for marginalized populations, have played a role in the high heart failure death rates. She stressed the need for new approaches in research, prevention, and clinical practice to address this concerning trend.