Analysis finds total reversal in heart failure deaths

Authors of a research letter in JAMA Cardiology report that declines in heart failure–related mortality from 1999 to 2012 have been entirely undone by reversals from 2012 to 2021.

This means that “contemporary [heart failure] mortality rates are higher than in 1999,” wrote researchers. “The origins of these reversals preceded the COVID-19 pandemic, although the larger increases in 2020 to 2021 indicate that the pandemic may have accelerated them due to limitations to health care access and possible cardiac involvement.”

Data from death certificates from a CDC database revealed that from 1999 to 2009, heart failure deaths dropped but then plateaued in 2012 and began to rise steadily, only to be accelerated upward once the COVID-19 pandemic began. In examining age, sex, race, and ethnicity, reversals were observed the most in males; non-Hispanic Black individuals; and those living in rural areas, in the South, and in Midwestern United States.

The most alarming spike, however, was seen related to age: the heart failure death rate for those under 45 years jumped 906% between 1999 and 2021, compared to increases of 364% for people 45 to 64 years old and 84% for individuals aged 65 and older.

Researchers admit that death certificate data can misattribute some deaths, like in cases when symptoms of heart failure cannot be easily differentiated from those due to other causes.