Exploring Heart Failure Mortality Trends and Disparities in Women: A Retrospective Cohort Analysis
Author Type(s)
Resident/Fellow
Document Type
Article
Publication Date
12-15-2023
DOI
10.1016/j.amjcard.2023.09.087
Journal Title
The American Journal of Cardiology
Department
Medicine
Keywords
Female, Humans, Cohort Studies, Ethnicity, Heart Failure, Retrospective Studies, United States, Racial Groups
Disciplines
Medicine and Health Sciences
Abstract
Heart failure (HF) remains a significant cause of morbidity and mortality in women. Population-level analyses shed light on existing disparities and promote targeted interventions. We evaluated HF-related mortality data in women in the United States to identify disparities based on race/ethnicity, urbanization level, and geographic region. We conducted a retrospective cohort analysis utilizing the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify HF-related mortality in the death files from 1999 to 2020. Age-adjusted HF mortality rates were standardized to the 2000 US population. We fit log-linear regression models to analyze mortality trends. Age-adjusted HF mortality rates in women have decreased significantly over time, from 97.95 in 1999 to 89.19 in 2020. Mortality mainly downtrended from 1999 to 2012, followed by a significant increase from 2012 to 2020. Our findings revealed disparities in mortality rates based on race and ethnicity, with the most affected population being non-Hispanic Black (age-adjusted mortality rates [AAMR] 90.36), followed by non-Hispanic White (AAMR 83.25), American Indian/Alaska Native (AAMR 64.27), and Asian/Pacific Islander populations (AAMR 37.46). We also observed that nonmetropolitan (AAMR 103.36) and Midwestern (AAMR 90.45) regions had higher age-adjusted mortality rates compared with metropolitan (AAMR 78.43) regions and other US census regions. In conclusion, significant differences in HF mortality rates were observed based on race/ethnicity, urbanization level, and geographic region. Disparities in HF outcomes persist and efforts to reduce HF-related mortality rates should focus on targeted interventions that address social determinants of health, including access to care and socioeconomic status.
Recommended Citation
Ibrahim, R., Shahid, M., Tan, M., Martyn, T., Lee, J. Z., & William, P. (2023). Exploring Heart Failure Mortality Trends and Disparities in Women: A Retrospective Cohort Analysis. The American Journal of Cardiology, 209, 42-51. https://doi.org/10.1016/j.amjcard.2023.09.087
