Racial and Ethnic Differences in Patient Age at First Hospitalization for Heart Failure
Key result
Black, Hispanic, and Asian patients face first HF hospitalization up to ~14 years earlier than Whites.
- P<0.01
- n=42,252
Journal of the American College of Cardiology published a graphical abstract
Its licence doesn't allow us to show a copy here.
Why the study?
The burden of HF varies across racial and ethnic groups, but differences in age at first HF hospitalization and the contribution of social risk factors remained to be characterized.
Study Design
Type
Observational (n=42,252)
Multicenter
Yes
Structured PICO
P
Population
42,252 patients hospitalized with a first heart failure diagnosis in the GWTG-HF registry between 2016 and 2019.
O
Outcome
Age at first HF hospitalization
Main Result
p-value: p=< 0.01
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Our study shows that social risk factors, including insurance status and area-level educational and economic opportunities, played a major role. These factors often limit people's access to quality health care and shape people's health long before they develop heart problems.”
SSSudip SahaAssistant chief of cardiology, Mid-Atlantic Kaiser Permanente
“They found it might have been due to various reasons, such as access to insurance, socioeconomic factors, the areas that they live, access to simple health care screening tools, like appointments, blood pressure monitoring, diabetes care.”
Implication
Non-Hispanic Asian, Black, and Hispanic patients experience their first heart failure hospitalization at a significantly younger age than non-Hispanic White patients, largely driven by differences in social and clinical risk factors.
Abstract
BACKGROUND The burden of heart failure (HF) varies across racial and ethnic groups. OBJECTIVES This study characterized the age at first HF hospitalization across racial and ethnic groups and determined the relative contribution of social risk factors to these differences. METHODS Patients hospitalized in the Get With The Guidelines-Heart Failure (GWTG-HF, 2016-2019) registry with no prior HF diagnosis were included. Age at first HF hospitalization captured in Get With The Guidelines-Heart Failure (GWTG-HF) was assessed among non-Hispanic (NH) Asian, NH Black, Hispanic, and NH White adults. We used Oaxaca-Blinder decomposition to estimate the proportion of racial and ethnic differences in clinical and social factors associated with age at first HF hospitalization. RESULTS Among 42,252 patients with first captured HF hospitalization in GWTG-HF, 2% self-identified as NH Asian, 24% as NH Black, 7% as Hispanic, and 67% as NH White. NH Asian, NH Black, and Hispanic patients were significantly younger than NH White patients at time of first HF hospitalization (70.6, 60.1, and 65.4 vs 73.6 years; P < 0.01). Differences in social and clinical risk factors across groups were significantly associated with younger age at first HF hospitalization for NH Asian, NH Black, and Hispanic patients by 1.2, 12.5, and 7.4 years, respectively, compared with NH White patients. CONCLUSIONS NH Asian, NH Black, and Hispanic patients were younger at the time of first HF hospitalization compared with NH White patients in the GWTG-HF registry. Differences in social and clinical factors explained a large proportion of the racial and ethnic differences in age at first HF hospitalization.
Discussion
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Cite This Study
Huang et al. (2025) conducted an observational in Heart failure (n=42,252). Non-White race and ethnicity (NH Asian, NH Black, Hispanic) vs. NH White race was evaluated on Age at first HF hospitalization (p=< 0.01). NH Asian, NH Black, and Hispanic patients were significantly younger at first heart failure hospitalization compared with NH White patients (70.6, 60.1, and 65.4 vs 73.6 years; P<0.01).