Abstract 12331: Cardiovascular Hospitalizations and Mortality Among Young Adults Aged 25 to 64 Years in the United States

Abstract

Introduction: Declines in cardiovascular mortality have stagnated in the United States since 2011. There is growing concern that these patterns may reflect worsening cardiovascular health in younger populations. However, little is known about how the burden of acute cardiovascular hospitalizations and mortality have changed in young adults. Aim: To evaluate cardiovascular hospitalizations (AMI, heart failure, ischemic stroke) and in-hospital mortality among adults 25-64 years, overall and by income-level, as well as population-level cardiovascular mortality. Methods: We determined age-standardized cardiovascular hospitalization rates from 2012 to 2019, and fit quasi-Poisson and quasi-binominal regression models to compare hospitalizations and mortality between low- and higher-income young adults. Results: Between 2012 and 2019, age-standardized AMI hospitalization rates increased modestly among young adults from 162.0 (161.4, 162.6) to 163.7 (163.3, 164.2) per 100,000 (p<0.001). In contrast, there were significant increases in heart failure (163.9 [163.3, 164.5] to 231.5 [231.0, 232.0], p<0.001) and ischemic stroke hospitalizations (92.3 [91.8, 92.8] to 110.2 [109.9, 110.6], p<0.001). Across all 3 conditions, low-income adults experienced a more pronounced rise in hospitalizations, and the gap between the low- and higher-income groups widened (p-interaction<0.001), while in-hospital mortality decreased for heart failure and stroke. Population-level cardiovascular mortality rates increased in the subgroup of young adults aged 45-64 years (162.5 to 168.3 per 100,000, p<0.001), particularly in the low-income population. Conclusions: There has been an alarming increase in cardiovascular hospitalizations and population-level cardiovascular mortality among young adults over the past decade in the US, with evidence of widening disparities between low- and higher-income populations.