Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.
Department of Medicine, Forrest General Hospital, Hattiesburg, Mississippi.
JAMA Cardiol. 2022 Sep 1;7(9):900-904. doi: 10.1001/jamacardio.2022.2213.
There are limited data on mortality trends in young adults with heart failure (HF).
To study the trends in HF-related mortality among young adults.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort analysis used mortality data of young adults aged 15 to 44 years with HF listed as a contributing or underlying cause of death in the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 1999 to December 2019. Analysis took place in October 2021.
Age 15 to 44 years with HF listed as a contributing or underlying cause of death.
HF-related age-adjusted mortality rates (AAMR) per 100 000 US population stratified by sex, race and ethnicity, and geographic areas.
Between 1999 and 2019, a total of 61 729 HF-related deaths occurred in young adults. Of these, 38 629 (62.0%) were men and 23 460 (38.0%) were women, and 22 156 (35.9%) were Black, 6648 (10.8%) were Hispanic, and 30 145 (48.8%) were White. The overall AAMR per 100 000 persons for HF in young adults increased from 2.36 in 1999 to 3.16 in 2019. HF mortality increased in young men and women, with men having higher AAMRs throughout the study period. AAMR increased for all race and ethnicity groups, with Black adults having the highest AAMRs (6.41 in 1999 and 8.58 in 2019). AAMR for Hispanic adults and White adults increased from 1.62 to 2.04 and 1.83 to 2.45 over the same time period, respectively. Across most demographic and regional subgroups, HF-related mortality stayed stable or decreased between 1999 and 2012, followed by an increase between 2012 and 2019. There were significant regional differences in the burden of HF-related mortality, with states in the upper 90th percentile of HF-related mortality (Oklahoma, South Carolina, Louisiana, Arkansas, Alabama, and Mississippi) having a significantly higher mortality burden compared with those in the bottom tenth percentile.
Following an initial period of stability, HF-related mortality in young adults increased from 2012 to 2019 in the United States. Black adults have a 3-fold higher AAMR compared with White adults, with significant geographic variation. Targeted health policy measures are needed to address the rising burden of HF in young adults, with a focus on prevention, early diagnosis, and reduction in disparities.
有关年轻人心力衰竭（HF）相关死亡率的趋势数据有限。
研究年轻人 HF 相关死亡率的趋势。
设计、设置和参与者：本回顾性队列分析使用了美国疾病控制与预防中心广域在线流行病学研究数据库中 1999 年 1 月至 2019 年 12 月期间因 HF 列为导致或潜在死因的 15 至 44 岁年轻人的死亡率数据。分析于 2021 年 10 月进行。
年龄为 15 至 44 岁，HF 列为导致或潜在死因。
按性别、种族和民族以及地理区域分层的每 100000 名美国人口 HF 相关年龄调整死亡率（AAMR）。
在 1999 年至 2019 年间，共有 61729 例 HF 相关死亡发生在年轻人中。其中，38629 人（62.0%）为男性，23460 人（38.0%）为女性，22156 人（35.9%）为黑人，6648 人（10.8%）为西班牙裔，30145 人（48.8%）为白人。年轻人 HF 的整体 AAMR 从 1999 年的每 100000 人 2.36 上升到 2019 年的每 100000 人 3.16。男性和女性的 HF 死亡率均有所上升，整个研究期间男性的 AAMR 均较高。所有种族和民族群体的 AAMR 均有所增加，黑人成年人的 AAMR 最高（1999 年为 6.41，2019 年为 8.58）。西班牙裔成年人和白人成年人的 AAMR 分别从 1.62 上升到 2.04 和从 1.83 上升到 2.45。在大多数人口统计学和地区亚组中，1999 年至 2012 年期间 HF 相关死亡率保持稳定或下降，随后在 2012 年至 2019 年期间上升。HF 相关死亡率的负担存在显著的地区差异，HF 相关死亡率排在前 90%的州（俄克拉荷马州、南卡罗来纳州、路易斯安那州、阿肯色州、阿拉巴马州和密西西比州）与排在后 10%的州相比，死亡率负担明显更高。
在美国，继最初的稳定期之后，2012 年至 2019 年期间年轻人 HF 相关死亡率上升。黑人成年人的 AAMR 比白人成年人高 3 倍，且存在显著的地域差异。需要采取有针对性的卫生政策措施来应对年轻人 HF 负担的增加，重点是预防、早期诊断和减少差异。
