Temporal and demographic disparities in mortality trends for heart failure and COPD-associated heart failure in U.S. Adults: A 1999–2020 analysis of CDC WONDER data

Abstract

Background

Heart failure (HF) carries varying mortality based on demographic distribution. Moreover, the interaction of HF with chronic obstructive pulmonary disease (COPD) raises this mortality. In this study, implementing national databases over a long time could assist in understanding mortality rates in patients suffering from two significant chronic diseases, HF and COPD.

Methods

This analysis utilized the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) system to assess the mortality trends between HF and COPD-associated HF in US adults aged 25–85+ from 1999 to 2020.

Results

This investigation detected a total of 6,755,700 deaths occurred in patients with HF in ages above 25. Fatalities of 1,141,819 (16.9 %) were associated with HF and comorbid COPD. Age-adjusted mortality Rates (AAMR) of HF-related deaths decreased from 162.7 to 154.4. (Average Annual Percentage Changes (AAPC): -0.49, 95 % CI: -0.63 to -0.34, p < 000001, while the overall AAMR for HF with COPD among adults increased from 24.5 in 1999 to 28.2 in 2020. Men had significantly higher HF-related AAMRs and HF with comorbid COPD-related mortality than women. HF-related AAMRs were highest among NH Black or African Americans, followed by NH Whites. At the same time, on the other side, HF and COPD had the highest mortality in non-Hispanic (NH) White individuals, followed by NH Black individuals, then Hispanic individuals. Mortality in HF with COPD was the highest in the Northeast, then the Midwest, South, and least in the West states.

Conclusion

Implementation of a CDC database provided guidance over two decades about the US population mortality attributed to HF with and without the presence of COPD, which contributed to a better understanding of national trends in prevailing diseases with remarkable chronicity.