Between 2014 and 2023, the incidence of heart failure in young adults increased by 20% (IRR 1.20), while one-year all-cause mortality modestly declined from 15.6 to 14.6 events per 100 person-years.
Cohort (n=19,537)
Yes
The incidence of heart failure in young adults in Hong Kong increased by 20% from 2014 to 2023, with a shift towards HFrEF and only modest reductions in one-year mortality despite increased use of guideline-directed medical therapy.
Absolute Event Rate: 14.6% vs 15.6%
p-value: p=0.006
Background: Heart failure (HF), traditionally considered a disease of the elderly, is increasingly common in younger people, but temporal data remain scarce. This cohort study aimed to examine temporal trends in incidence, comorbidities, risk factor profiles, and clinical outcomes among young HF patients. Methods: Using a territory-wide administrative database in Hong Kong, we identified 19,537 young adults aged <65 years with incident HF between 2014 and 2023. Data on baseline characteristics, echocardiographic parameters, comorbidities and prescribed medications were retrieved. Annual standardised incidence rates (IRs) of HF were calculated by direct age- and sex-standardisation. Comparisons were made between two 5-year periods: 2014-2018 and 2019-2023. Multivariable regression models were applied to assess temporal shifts in risk factor profiles. The primary outcome was one-year all-cause mortality, with incidence rates reported per 100 person-years. Kaplan-Meier survival curves were plotted to illustrate survival trends. Findings: < 0.001). Additionally, the 2019-2023 cohort demonstrated elevated subtype of HF with reduced ejection fraction (HFrEF) and increased use of guideline-directed medical therapy (GDMT). A modest reduction in one-year mortality was observed between the two periods (15.6 14.8, 16.5 vs. 14.6 13.8, 15.5 events per 100 person-years). Interpretation: The incidence of HF among young adults increased substantially between 2014 and 2023. During this period, the risk factor profile shifted considerably, with a pronounced rise in HFrEF subtype. Despite improved therapeutic management and better use of GDMT, reductions in one-year mortality were modest. Proactive public health strategies are urgently needed to address these emerging challenges in this population. Funding: This work was funded by grants from the National Natural Science Foundation of China (No. 82270400) and the Natural Science Foundation of Guangdong Province (No. 2023A1515010731).
Gu et al. (Mon,) conducted a cohort in Heart failure in young adults (n=19,537). Diagnosis in 2019-2023 vs. Diagnosis in 2014-2018 was evaluated on One-year all-cause mortality (events per 100 person-years) (p=0.006). Between 2014 and 2023, the incidence of heart failure in young adults increased by 20% (IRR 1.20), while one-year all-cause mortality modestly declined from 15.6 to 14.6 events per 100 person-years.