Heart failure deaths rising in younger adults

Death rates due to heart failure are now increasing, and this increase is most prominent among younger adults under 65, considered premature death, reports a new Northwestern Medicine study.

The increase in premature death from heart failure was highest among black men under age 65.

This study is showing for the first time that death rates due to heart failure have been increasing since 2012. The rise in deaths comes despite significant advances in medical and surgical treatments for heart failure in the past decade. 

The study was published May 6 in the Journal of the American College of Cardiology.  

“The success of the last three decades in improving heart failure death rates is now being reversed, and it is likely due to the obesity and diabetes epidemics,” said Dr. Sadiya Khan, assistant professor of medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine cardiologist. “We focused on patients with heart failure because they have the highest mortality related to cardiovascular death. They have a prognosis similar to metastatic lung cancer.”

An estimated 6 million adults in the U.S. have heart failure. It’s the number one reason older adults are admitted to the hospital, Khan said. 

“Given the aging population and the obesity and diabetes epidemics, which are major risk factors for heart failure, it is likely that this trend will continue to worsen,” she said.

Recent data that show the average life expectancy in the U.S. also is declining, which compounds Khan’s concern that cardiovascular death related to heart failure may be a significant contributor to this change. 

The study used data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research data, which includes the underlying and contributing cause of death from all death certificates in the U.S. between 1999 to 2017 for 47,728,569 individuals. Researchers analyzed the age-adjusted mortality rate for black and white adults between the age of 35 to 84 years who died from heart failure. 

Simply put, heart failure is when the heart muscle doesn’t function properly in its squeezing or relaxing functions. It causes symptoms like shortness of breath and swelling. When the heart can’t adequately squeeze to pump blood, it’s called heart failure with reduced ejection fraction; when the heart can’t relax it’s called heart failure with preserved ejection fraction.

“To combat this disturbing trend, we need to focus on improving the control of risk factors, including blood pressure, cholesterol and diabetes,” Khan said. “Healthy lifestyle changes promoting a normal body mass index also can protect from developing heart failure as well as engaging in regular physical activity and consuming a healthy, well-balanced diet.” 

In future research, Khan said she wants to better understand what causes the disparities in cardiovascular death related to heart failure. 

Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, grant KL2TR001424.

Other Northwestern authors include first author Dr. Peter Glynn and Dr. Donald M. Lloyd-Jones, Dr. Matthew J. Feinstein and Mercedes Carnethon.