Exploring Heart Failure Mortality Trends and Disparities in Women: A Retrospective-Cohort Analysis

Heart failure (HF) remains a significant cause of morbidity and mortality in women. Population-level analyses shed light on existing disparities and promote targeted interventions. We evaluated HF-related mortality data in women in the United States (US) to identify disparities based on race/ethnicity, urbanization level, and geographic region. We conducted a retrospective cohort analysis utilizing the CDC Wide-ranging Online Data for Epidemiologic Research database to identify HF-related mortality among the death files from 1999 to 2020. Age-adjusted HF mortality rates were standardized to the 2000 US population. We fit log-linear regression models to analyze mortality trends. Age-adjusted HF mortality rates in women have decreased significantly over time, from 97.95 in 1999 to 89.19 in 2020. Mortality mainly downtrended from 1999 to 2012, followed by a significant uprise from 2012 to 2020. Our findings revealed disparities in mortality rates based on race and ethnicity, with the most affected population being non-Hispanic Black (AAMR: 90.36), followed by non-Hispanic White (AAMR: 83.25), American Indian/Alaska Native (AAMR: 64.27), and Asian/Pacific Islander populations (AAMR: 37.46). We also observed that non-metropolitan (AAMR: 103.36) and Midwestern (AAMR: 90.45) regions had higher age-adjusted mortality rates compared to metropolitan (AAMR: 78.43) regions and other US census regions. In conclusion, significant differences in HF mortality rates were observed based on race/ethnicity, urbanization level, and geographic region. Disparities in heart failure outcomes persist and efforts to reduce HF-related mortality rates should focus on targeted interventions that address social determinants of health, including access to care and socioeconomic status.