Trends of heart failure associated mortality in premenopausal women in the United states 1999-2020

Abstract Background Heart Failure (HF)-related mortality has been showing an upward trend since 2012. In this study, we assessed nationwide trends in mortality related to HF among women and focused on women 15-55 years of age in the United States from 1999 to 2020. Methods Trends in mortality related to HF were assessed through a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research database. Age-adjusted mortality rates per 1,000,000 people and associated annual percent changes with 95% Confidence Intervals(CI) were determined. Joinpoint regression was used to assess the trends in the overall, demographic (sex, race and ethnicity, age), and regional groups. Results Between 1999 and 2020, 1,035,383 women died of heart failure. The age-adjusted mortality rate remained stable from 1999-2005, saw a reduction till 2012 and then an increase till 2020. Higher mortality rates were observed for Black patients, and patients ≥55 years of age. Large metropolitan counties had lesser mortality burden compared to rural counterparts. In 15-55 age group,18,875 women died due to heart failure.The discrepancy in mortality rates was even more pronounced between races in 15-55 age group. Conclusions Following an initial period of stability, HF-related mortality in women worsened from 2012 to 2020 in the United States. Black women had higher AAMR compared with White women, with a significant geographic variation. In the premenopausal group, black women had 4 times worse AAMR compared to their white counterparts. Focus towards preventative medicine, early diagnosis, and bridging the disparities, including socioeconomic, to promote healthcare equality should be upheld.