An unprecedented number of people are dying from heart failure, completely reversing long-standing declines in cardiovascular mortality rates observed just two decades ago.

“What the paper shows is that more patients die from heart failure now than 20 years ago. The concerning thing about it is that we made good strides in improving that trend for a decade, and the last decade, that trend reversed,” senior author Dr. Marat Fudim, a heart failure cardiologist at the Duke University Medical Center, told The Epoch Times.

Although the researchers found typical disparities between men and women and among certain racial and ethnic groups, the greatest increase in heart failure-related deaths occurred among individuals younger than 45.

According to the study, between 1999 and 2021, there was a reversal in the death rate of 906 percent among people under 45 years old, 385 percent among people 45 to 64 years old, 84 percent for those 65 and older, and 103 percent overall. The analysis observed similar results when looking at heart failure as the underlying cause of death.

Heart failure, also known as congestive heart failure, is a severe medical condition that occurs when the heart cannot pump enough blood to meet the body’s needs. This can happen either because the heart can’t fill up with enough blood or it is too weak to pump properly. The condition can come on suddenly or develop over time and can affect the left or right side of the heart.

Heart failure can also lead to other conditions like pulmonary hypertension, irregular heartbeat, heart valve disease, and sudden cardiac arrest.

Dr. Fudim provided several reasons that may explain higher death rates from heart failure. First, the prevalence of patients with heart failure is on the rise, which subsequently leads to more deaths in patients from and with heart failure. However, heart failure trends have been gradually increasing for decades, so this alone can’t explain the “U-shaped trend we showed,” he said.

Second, the United States isn’t focused on cardiovascular disease prevention. Third, comorbidities such as diabetes, obesity, hypertension, liver disease, and renal disease have been rising for a few decades and are now translating to worse heart failure-related outcomes.

“This hits younger generations specifically. This would make an ‘average’ heart failure patient sicker, so to say,” Dr. Fudim said.

Fourth, it has become harder for people to access health care, medical providers, and needed treatment, especially in the “urban/rural divide,” where the rural mortality rate is significantly higher.

“Last but not least, this trend […] preceded COVID by many years but has not been helped by COVID—and the impact it had on health care, preventive services, worsening socioeconomic divide, etc.,” Dr. Fudim added.

Dr. Andrew Foy, a cardiologist at Penn State, told The Epoch Times in an email that he cannot draw any conclusions about the incidence rates shifting to younger populations since the data deals exclusively with age-adjusted mortality rates.

“We have to seriously consider the impact (or lack thereof) of new therapies and interventions on HF [heart failure] disease management,” Dr. Foy said.

Dr. Foy noted some “treatment gaps” could only get better as products were not available before 2012.

“To me, this data highlights the concept of the ‘Efficacy-Effectiveness Gap’ for new therapies and interventions, which are tested in perfect conditions and patients in clinical trials and may not translate to real-world patient populations. I think, at the very least, we must consider this here and contextualize it with the increasing costs of new treatments in HF patients,” he said.