An overview of the association between socioeconomic deprivation and heart failure.

Abstract

Although geographic variations exist in heart failure (HF), the prevalence of HF is increasing worldwide with a higher rise in low-income countries (LICs) and lower-middle-income countries (L-MICs). HF has enormous socioeconomic impact and is a leading contributor to global healthcare expenditure. Individual and composite measures of socioeconomic deprivation (SED) have consistently been linked to HF incidence as well as HF-related hospitalization and mortality. In socioeconomically disadvantaged populations, composite measures of SED are more powerful predictors of HF outcomes than individual indices. The relationship between SED and HF is bi-directional. While SED predisposes to HF, HF on its part aggravates economic hardship due to increased time away from work, job loss, and financial instability. In this review, we will discuss the associations between individual and composite measures of SED and HF, while highlighting the differences that exist between LICs, L-MICs, upper-middle-income countries (U-MICs), and high-income countries (HICs). We will also propose actionable items that could be pursued to mitigate the adverse effects of SED on HF.