The following is a summary of “Trends in Heart Failure–Related Mortality Among Older Adults in the United States From 1999-2019” published in the November 2022 issue of Heart Failure by Siddiqi et al.

The population of the United States is aging, and the burden of heart failure (HF) is increasing. However, the trends in HF-related mortality among adults over the age of ≥75 have not been studied. The goal of this study was to look at trends and regional differences in HF-related mortality among older Americans. From 1999 to 2019, death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Range OnLine Data for Epidemiologic Research) database were analyzed for HF-related mortality in adults ≥75 years of age. Annual percent change (APC) and age-adjusted mortality rates (AAMRs) per 10,000 people were calculated and stratified by year, gender, race/ethnicity, and geographic region. Between 1999 and 2019, 5,014,919 adults over the age of ≥75 died due to heart failure. 

The AAMR fell from 141.0 in 1999 to 108.3 in 2012 (APC: -2.1; 95% CI-: 2.4 to -1.9), then rose to 121.3 in 2019 (APC: 1.7; 95% CI: 1.2-2.2). From 1999 to 2019 (AAMR men: 158.3 vs. women: 131.0), men had consistently higher AAMR than women (AAMR men: 141.1 vs. women: 107.8). Non-Hispanic (NH) White adults had the highest overall AAMR (127.2), followed by NH Black adults (108.7), NH American Indian/Alaska Native adults (102.0), Hispanic or Latino adults (78.0), and NH Asian or Pacific Islander adults (78.0). About (57.1) AAMR differed significantly by region (overall AAMR: Midwest 133.9; South: 119.2; West: 116.3; Northeast: 113.5), with nonmetropolitan areas having higher HF-related AAMR (147.0) than metropolitan areas (115.2). Mississippi, Oklahoma, West Virginia, Oregon, and Indiana were in the top 90th percentile of HF-related AAMR, with nearly double the AAMRs of states in the lower 10th percentile. 

Following a period of steady decline, HF-related mortality in  ≥75-year-old adults in the United States has increased since 2012. The highest AAMRs were found in White adults and men and patients from the Midwestern and nonmetropolitan United States. To reduce the rising rates of HF-related mortality, targeted strategies for preventing and treating HF in older adults are required.