Heart failure-related hospitalizations, mortalities see downward trend

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Heart failure-related hospitalizations and in-hospital mortalities have decreased significantly since the turn of the millennium, the American Heart Association has reported, despite a general increase in the burden of heart failure (HF) comorbidities.

Emmanuel Akintoye, MD, MPH, led a retrospective study of more than a decade of heart failure statistics from 2001 to 2014, a period of time during which an estimated 57.4 million HF-related hospital admissions occurred in the U.S. Though Akintoye and colleagues’ findings were positive, the changes have been gradual, and nearly a million American patients are newly diagnosed with HF each year, the authors wrote in the Journal of the American Heart Association. Between 2012 and 2030, they said, the prevalence of heart failure is still expected to increase by 46 percent, which would result in eight million more diagnoses.

Between 2001 and 2014, an estimated 57 million patients were admitted to U.S. hospitals with either a primary or secondary diagnosis of heart failure. In all, more than 75 percent of these patients were 65 years of age or older, and 53.5 percent were women. The majority were white and enrolled in Medicare insurance programs. Geographically, the south saw 40.2 percent of the whole country’s admissions.

Akintoye et al. studied data from the National Inpatient Sample and U.S. Census Bureau, dividing the data by four-year increments. The new century started off on a good foot, seeing a 3.4 percent decrease in HF-related admissions and mortalities between 2001 and 2005, the authors reported. The trend steadied for a few years between 2006 and 2009, reaching just a 1.1 percent decrease, but fell again between 2010 and 2014, when primary HF admission continued to decline at an average annual rate of 4.3 percent.

The greatest improvements in heart failure stats, Akintoye and colleagues wrote, coincided with the 2005 publication of new American College of Cardiology and American Heart Association HF guidelines.

“Despite an increase in comorbidity burden, primary HF hospitalization and HF-associated in-hospital mortality declined in the United States between 2001 and 2014,” the authors wrote. “There seems to be a further decline in HF-associated admissions and in-hospital mortality among patients with a secondary diagnosis of HF after the publication of the 2005 ACC/AHA HF management guidelines compared with the preceding trend. However, little further improvement was observed beyond 2009 during the study period.”