Gender Disparities In Heart Failure Related Mortality Rates Among Older Adults; Data From CDC Wonder 1999-2019

Abstract

Background Heart failure accounts for significant morbidity and mortality in the elderly population. However, sex differences among elderly patients with heart failure are not clear. The aim of this study was to characterize trends in heart failure related deaths stratified based on sex in elderly population in the United States from 1999 to 2019. Methods We used CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) to access National Vital Statistics System data from 1999 to 2019. Heart failure related deaths in elderly (defined as age >/= 75 years) were identified using the International Classification of Diseases, Tenth Revision, codes from multiple causes of death and were represented as crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to examine changes in trend and annual percentage change (APC) in heart failure related deaths overall and stratified by sex. Results AAMR related to heart failure in the elderly decreased from 1409.97 per 100,000 in 1999 to 1082.67 per 100,000 in 2012 (APC -2.1[95% CI, −2.4 to −1.9]) and then increased to 1209.56 per 100,000 in 2019 (APC 1.7[95% CI, 1.1 to [95% CI, −2.4 to −1.92.3]). The AAMR was higher in men (1379.24) than in women (1104.47). AAMR decreased significantly in both sexes till 2012 followed by significant increase till 2019 in men (APC 1.9 [95% CI, 1.4 to 2.4]), and women (APC 1.4 [95% CI, 0.9 to 1.8]) Figure 1 illustrates these results. On subgroup analysis, men between age 75-84 (802.49) had higher CMR compared to women (576.2) in the same age group. Similarly in the age group 85 and above, men had higher CMR (3041.1), when compared to women (2631.9). Conclusion Heart failure related mortality in the elderly in both genders has been increasing since 2012. Mortality rates are higher in men compared to women in this age group. Further research is required to understand the increase in the rates of mortality as well as the cause of these disparities to help develop better preventative strategies. Heart failure accounts for significant morbidity and mortality in the elderly population. However, sex differences among elderly patients with heart failure are not clear. The aim of this study was to characterize trends in heart failure related deaths stratified based on sex in elderly population in the United States from 1999 to 2019. We used CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) to access National Vital Statistics System data from 1999 to 2019. Heart failure related deaths in elderly (defined as age >/= 75 years) were identified using the International Classification of Diseases, Tenth Revision, codes from multiple causes of death and were represented as crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to examine changes in trend and annual percentage change (APC) in heart failure related deaths overall and stratified by sex. AAMR related to heart failure in the elderly decreased from 1409.97 per 100,000 in 1999 to 1082.67 per 100,000 in 2012 (APC -2.1[95% CI, −2.4 to −1.9]) and then increased to 1209.56 per 100,000 in 2019 (APC 1.7[95% CI, 1.1 to [95% CI, −2.4 to −1.92.3]). The AAMR was higher in men (1379.24) than in women (1104.47). AAMR decreased significantly in both sexes till 2012 followed by significant increase till 2019 in men (APC 1.9 [95% CI, 1.4 to 2.4]), and women (APC 1.4 [95% CI, 0.9 to 1.8]) Figure 1 illustrates these results. On subgroup analysis, men between age 75-84 (802.49) had higher CMR compared to women (576.2) in the same age group. Similarly in the age group 85 and above, men had higher CMR (3041.1), when compared to women (2631.9). Heart failure related mortality in the elderly in both genders has been increasing since 2012. Mortality rates are higher in men compared to women in this age group. Further research is required to understand the increase in the rates of mortality as well as the cause of these disparities to help develop better preventative strategies.