Heart failure, hypertensive deaths rise in black women and men

August 20, 2020

CHICAGO--- Deaths due to heart failure and hypertensive heart disease are increasing in the U.S. --particularly in Black women and men -- despite medical and surgical advances in heart disease management, reports a new Northwestern Medicine study.

The study for the first time comprehensively characterizes mortality between 1999-2018 across a spectrum of heart disease types and examines differences between sex and racial groups across age groups and geography. Although ischemic heart disease (coronary artery disease) remains the leading cause of heart disease deaths, the study reports heart failure and hypertensive heart disease is growing rapidly.

"These findings are alarming," said senior study author Dr. Sadiya Khan, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "Despite medical and surgical advances in heart disease management and public policy initiatives around blood pressure awareness, we are losing ground in the battle against heart failure and hypertension. And the disparities in heart disease are clear."

Between 2011-2018, the death rate due to heart disease declined by 0.7% per year. Over this same time period, the death rate due specifically to ischemic heart disease (coronary artery disease) declined by 2.6% per year. But these gains were offset by significant increases in deaths due to heart failure (3.5% per year) and hypertensive heart disease (4.8%/year).

In total, deaths from heart disease in 2018 accounted for 3.8 million potential years of life lost with 30% and 60% greater years of life lost for Blacks compared with white men and women, respectively.

The study will be published Thursday in the British Medical Journal.

The disparities observed in heart failure and hypertensive heart diseases are likely due to higher rates of high blood pressure, obesity and diabetes in Black women and men, Khan said.

"But, we have to recognize and address that the root causes of these disparities arise from differences in social determinants of health, such as socioeconomic status and access to care, and structural and systemic racism in our country," Khan said.

Knowing the types of heart disease that are increasing, and in which groups, can help inform how to equitably target prevention earlier in life, especially for heart failure and hypertension, noted study first author Dr. Nilay Shah, instructor of cardiology and preventive medicine at Feinberg and a Northwestern Medicine physician.

"These findings should be a wake-up call that without equitable access to care and community-engaged implementation of evidence-based therapies for the people who need them, we will not be able to reverse these unfavorable trends," Khan said.

The study used standard data collected from death certificates across the country to identify trends across time in deaths from leading causes of heart disease deaths (ischemic heart disease, heart failure, heart disease related to high blood pressure, valvular heart disease, arrhythmias, heart disease related to lung disease, and other heart diseases), in Black and white women and men, across age groups and in urban and rural areas. The data source was the Centers for Disease Control and Prevention's WONDER database.

"These findings emphasize the urgency with which we need to change how we are approaching cardiovascular health, which continues to be reactive and shift towards a proactive/preventive approach," Khan said. "We need to set up the systems and resources to help our patients preserve and protect their heart health. We needed this before the COVID-19 pandemic and the need is even more urgent with disparities in the context of the current pandemic. People with high blood pressure or obesity have more severe outcomes related to COVID-19. This might portend even greater increases in heart disease deaths in the long-term among people who recover from it."
Northwestern co-authors include Mercedes Carnethon and Dr. Donald Lloyd-Jones.

The research was supported by the National Heart, Lung, and Blood Institute (NHLBI) grant number F32HL149187 (to Nilay Shah), National Center for Advancing Translation Sciences grant number KL2TR001424 (to Sadiya Khan), and the American Heart Association grant number 19TPA34890060 (to Sadiya Khan).

Northwestern University

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.