The proportion of younger heart failure patients aged 35-64 is rising, with mortality increasing faster in this group compared to older adults.
Summary: A new report from the Heart Failure Society of America reveals a rise in the prevalence and mortality of heart failure in the US and highlights an alarming trend, with younger adults (ages 35-64) experiencing higher rates of heart failure and mortality compared to older populations. Additionally, the report emphasizes worsening racial disparities, with Black, American Indian, and Alaska Native individuals seeing the highest mortality rates. Inconsistent reporting practices and lack of timely medical interventions are cited as contributing factors to these trends.
Three Key Takeaways:
- Heart Failure Increasing Among Younger Adults – The proportion of heart failure patients aged 35-64 is growing, with mortality rising faster in this group compared to older adults.
- Worsening Racial Disparities – Black, American Indian, and Alaska Native individuals continue to experience the highest heart failure mortality rates, with these disparities increasing over time.
- Projected Surge in Prevalence – The number of Americans with heart failure is projected to rise significantly, reaching 11.4 million by 2050.
The latest findings on heart failure by the Heart Failure Society of America reveal a concerning rise in the prevalence, mortality, and impact of this condition in the United States.
According to a report published in the Journal of Cardiac Failure, approximately 6.7 million Americans over the age of 20 currently live with heart failure, a figure projected to rise to 8.7 million by 2030, 10.3 million by 2040, and 11.4 million by 2050.
This year’s findings underscore “some of the most alarming trends seen in heart failure in recent years,” according to a release from the Heart Failure Society of America. While heart failure rates have steadily increased over the last decade, the 2024 report shows that the problem is growing even more severe, particularly in younger populations, racial and ethnic minority groups, and those with multiple health conditions.
Challenges With Implementation and Reporting
The report also identifies challenges with implementation and reporting. Despite established guidelines emphasizing the timely initiation of guideline-directed medical therapies (GMDT), the data indicate that implementation is falling short, which may be fueling the increase in both mortality and hospitalization rates for heart failure, particularly among at-risk populations.
Inconsistent coding practices that fail to recognize heart failure as a primary underlying cause of death may lead to under-detection and under-reporting of heart failure deaths, suggesting that the actual burden of heart failure may be higher than current data shows.
‘A Wake-up Call for Clinicians’
“The shifts in age distribution, worsening in mortality rates, widening racial and ethnic disparities —which may be a reflection of systematic and structural barriers to appropriate and timely health care—should be a wake-up call for clinicians, payers, legislators, funding agencies, and the overall healthcare system,” says Biykem Bozkurt, MD, PhD, Baylor College of Medicine and chair of the HFSA Data in Heart Failure Committee, in a release.
Bozkurt continues, “We need to address worsening trends in heart failure, not only through medical interventions and properly implemented GDMT, but by tackling the growing challenges in health care regarding access and coverage for appropriate and timely care, the effect of mis-incentivization of wrong care such as inappropriate discontinuation of therapies, and social determinants of health that are driving widening disparities.”
Key Findings
The HF Stats 2024: Heart Failure Epidemiology and Outcomes Statistics highlights several key findings:
- Greater Impact on Younger Patients: The proportion of younger patients (aged 35-64) with heart failure has increased, showing a higher annual rise in mortality compared to older adults. This trend suggests that heart failure is no longer just a disease of aging but one that is increasingly affecting younger populations.
- Mortality Surge in 2021: While the 2023 report noted an upward trend in heart failure-related deaths since 2012, the 2024 report reveals a significant acceleration in 2020-2021, when 425,147 deaths were linked to heart failure, accounting for 45% of cardiovascular deaths.
- Racial Disparities Worsening: As in previous years, Black, American Indian, and Alaska Native individuals continue to have the highest all-cause age-adjusted heart failure mortality rates. The mortality rate for Black individuals has risen faster than any other racial or ethnic group, particularly in those under 65. The overall prevalence of heart failure has also increased among Black and Hispanic populations.
- Impact of Comorbidities: Obesity and hypertension remain critical risk factors for heart failure, but the 2024 report emphasizes the rising threat of clusters of comorbidities—multiple health conditions that are compounding the risk of heart failure.
- COVID-19 Impact: For the first time, this year’s report noted that heart failure hospitalization rates were temporarily reduced between 2020-2022 due to the pandemic. However, long-term trends still show a steady increase in hospitalizations across all age groups and racial categories, with Black patients disproportionately affected.
Along with the inaugural report, the Heart Failure Society of America launched HFStats.org, an online repository of heart failure statistics, complete with fact sheets, infographics, and other downloadable materials.