Heart Failure Mortality Rates Soar: Highest in 20 Years

A new analysis shows that the number of deaths from heart failure, especially among people under 45, jumped sharply from 2012 to 2021, completely reversing declines observed from 1999 to 2012.

Scientists have uncovered a concerning trend in heart failure mortality in the United States by using data from the U.S. Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiological Research.

The study, published on April 24 in JAMA Cardiology, found that declining death rates observed in the early 2000s have been completely reversed, with more people dying from the condition now than over two decades ago.

The data showed that in 1999, just over 105 people per 100,000 died from heart failure. However, that rate dropped to approximately 81 per 100,000 around 2012. From that point on, heart failure-related deaths gradually increased, then rose sharply between 2019 and 2021 to 106 people per 100,000.

The second highest rates occurred in individuals 45 to 64 years old, followed by men and non-Hispanic Black individuals.

People living in rural areas, the South, and Midwestern states also experienced a significant reversal in mortality rates.

"Our analysis shows that declines in heart failure-related mortality from 1999 to 2012 have been entirely undone by reversals from 2012 to 2021, meaning that contemporary heart failure mortality rates are higher than in 1999," the study's authors wrote.

While the data showed that heart failure-related deaths began rising before the COVID-19 pandemic, the researchers suggest that pandemic-related factors likely played a role in the sharp uptick observed from 2020 to 2021. These factors include limited access to health care during COVID lockdowns and heart problems possibly associated with COVID-19.

However, the study did have some limitations. For example, the scientists used death certificate data, which may have misreported the cause of death in some people, especially during the height of the COVID-19 pandemic. Moreover, changes in diagnostic methods and the fact that people are living longer with conditions like heart disease, which can lead to heart failure, could have influenced the results.

Why are heart-related deaths increasing among young adults?

The study's results showed a significant increase in mortality among younger people, which parallels the rise in obesity, type 2 diabetes, and other heart disease risk factors occurring in this age group.

For example, research published in 2023 found that the rates of obesity among adults ages 20 to 44 years increased from 32.7% in 2009 to nearly 50% in 2020. Diabetes rates also rose by just over 1% during that time frame.

Moreover, adults in the U.S. may not be getting enough physical activity to ward off heart issues. According to CDC data, only around 24% of adults 18 years and older met the Physical Activity Guidelines for Americans in 2020.

Though rare, reports of myocarditis or inflammation of the heart muscle in young people after COVID-19 vaccination may be another pandemic-related factor. According to the National Institutes of Health (NIH), myocarditis can lead to heart failure and other cardiovascular conditions.

However, a study recently published in Heart found that COVID-19 vaccination reduced the risk of post-COVID cardiac conditions, including heart failure.

Heart arrhythmias such as atrial fibrillation (AFib) can also lead to heart failure. Recent research found that AFib is impacting more younger people than previously thought.

Still, while these factors may contribute to the stark reversal in heart failure mortality rates identified in the study, the root cause behind the rising prevalence of cardiovascular conditions among young people remains unclear.