The contemporary trends and geographic variation in premature mortality due to heart failure from 1999 to 2018 in the United States

Ali Raza Ghani; Mohsin Sheraz Mughal; Sundeep Kumar; Sara Aslam; Mahboob Alam; Mohammed Haris Usman; Deanna Mikhalkova

doi:10.1016/j.ijcha.2021.100812

The contemporary trends and geographic variation in premature mortality due to heart failure from 1999 to 2018 in the United States

Int J Cardiol Heart Vasc. 2021 Jun 7:34:100812. doi: 10.1016/j.ijcha.2021.100812. eCollection 2021 Jun.

Authors

Ali Raza Ghani¹, Mohsin Sheraz Mughal², Sundeep Kumar¹, Sara Aslam³, Mahboob Alam⁴, Mohammed Haris Usman⁵, Deanna Mikhalkova¹

Affiliations

¹ The Department of Medicine, Division of Cardiology Saint Louis University Hospital, MO, USA.
² The Department of Medicine, Monmouth Medical Center, an affiliate of RWJ/Barabas Healthcare System, Long Branch, NJ, USA.
³ University Medical and Dental College, Faisalabad, Pakistan.
⁴ The Department of Medicine, The Section of Cardiology, Baylor College of Medicine, One Baylor Plaza, MS BCM620, Houston, TX 77030, USA.
⁵ The Department of Medicine, Section of Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA.

Abstract

Objectives: We aimed to examine the contemporary trends and regional variations in premature mortality due to heart failure across the U.S. from 1999 to 2018.

Background: For most U.S. census regions, it is unknown whether premature mortality (deaths among persons under age 65) due to heart failure is increasing -or decreasing.

Methods: In this descriptive study, the death certificate data were retrieved from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database and examined from 1999 to 2018 for the underlying cause of death. Age-adjusted mortality rates (AAMR) per 100,000 persons and annual percent change (APC) in rates stratified by census region were calculated using Joinpoint trend analysis software.

Results: There were 118,116 premature deaths due to heart failure from 1999 to 2018 across the U.S. Of these 52.40% of deaths were reported in the South, 20.30% in the Midwest, 15.10% in the West, and 12.20% in the Northeast. The AAMRs were the highest in the South region (range: 3.1-4.9) and the lowest in the Northeast region (range: 1.5-1.9). There was an overall decline in mortality across all regions from 1999 till 2011-2012. However, mortality has an upward trajectory throughout all the census regions after 2012.

Conclusions: This study on nationwide data showed that overall premature mortality due to heart failure declined from 1999 to 2011-2012 followed by an upward trajectory from 2012 to 2018; the explanation for this merits further discovery.

Keywords: Census regions; Disparities; Heart failure; Premature mortality.