Researchers investigated geographic disparities in heart failure outcomes in states with the highest and lowest life expectancies. Disparities in heart failure mortality and incidence, as well as the decline in survival rates of heart failure patients, emphasize the need for appropriate treatment strategies.
Geographic disparities in life expectancy (LE) exist in the United States, which may have various genetic, behavioral, and socio-environmental causative factors. However, the exact reasons for these disparities are not entirely clear. Still, heart failure (HF) is believed to be a leading contributor to geographic disparities in LE in the United States, with about one in eight deaths being caused by heart failure each year.
Researchers conducted a secondary data analysis of HF outcomes in older patients over 65. Data from the Center for Disease Control and Prevention-sponsored Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database and a nationally representative 5% sample of Medicare beneficiaries from the year 2000 to 2017. HF mortality, incidence, prevalence, and survival were compared across the leading states (such as Hawaii, Florida, Arizona, Colorado, and California) and lagging states (such as Arkansas, Louisiana, Tennessee, and Oklahoma) in LE.
According to the results, HF mortality rates were higher in the lagging states than in the leading states. In addition, HF incidence, prevalence, and pre-existing prevalence at age 65 were higher in the lagging states versus the leading states. Populations in the lagging states were found to have a greater risk of HF incidence and death after an HF diagnosis in the lagging states. A decline in survival with HF was found in both leading and lagging states.
The geographic disparities in HF mortality, incidence, prevalence, and survival warrant the need for effective HF prevention strategies. Healthcare providers are encouraged to optimize treatment strategies based on modifiable risk factors and early management of the disease to prevent poor outcomes.
Yu, B., Akushevich, I., Yashkin, A. P., Yashin, A. I., Lyerly, H. K., & Kravchenko, J. (2022). Epidemiology of geographic disparities in heart failure among US older adults: a Medicare-based analysis. BMC Public Health, 22(1), 1280. https://doi.org/10.1186/s12889-022-13639-2