Age-adjusted Trends in the Diastolic and Systolic Heart Failure in the United States Over Recent Years Based on Race and Gender, With Higher Trends in Men and African Americans.

BACKGROUND

Heart failure (HF) is a leading cause of hospitalization in the United States. The goal of this study was to evaluate contemporary population-level trends and demographic disparities in age-adjusted hospitalization rates for systolic heart failure (SHF) and diastolic heart failure (DHF).

METHODS

We analyzed discharge data from the National Inpatient Sample database, years 2016 to 2020, for adults aged 20 and older. HF subtypes were identified using International Classification of Diseases, Tenth Revision codes. Age-adjusted hospitalization rates per 100,000 population were calculated and stratified by year, sex, and race.

RESULTS

From 2016 to 2020, the age-adjusted DHF hospitalization rate increased from 219.4 [95% confidence interval (CI), 201.4-237.1] to 303.1 (95% CI, 277.7-328.5) per 100,000. SHF rates rose from 211.7 (95% CI, 194.7-228.7) to 262.6 (95% CI, 240.6-284.6). Hospitalizations for SHF were more common in men than women across all years; in 2020, the SHF hospitalization rate in men was 370.6 (95% CI, 323.8-417.4) compared to 171.9 (95% CI, 152.6-191.1) in women. Black patients consistently had the highest SHF and DHF hospitalization rates. In 2020, the DHF rate among Blacks was 418.3 (95% CI, 328.9-507.7) versus 284.8 (95% CI, 255.0-314.6) among Whites, and the SHF rate was 403.6 (317.3-478.8) versus 227.5 (95% CI, 203.7-251.3), respectively.

CONCLUSIONS

SHF and DHF age-adjusted hospitalization rates are rising significantly, with pronounced disparities by sex and race. Men and Black patients are disproportionately impacted.