Kaiser Permanente Study Results Suggest Link Between Older Age, Heart Failure

What do an aging population alongside a rise in deaths related to heart failure (HF) mean for the healthcare system? According to publicly available CDC data, the population over age 65 grew more than 5-fold in just 8 years (22.9%, or 9.5 million) during the past decade, and deaths from HF among the group rose nearly as fast. Regarding costs for patients aged 65 to 79 years and at least 80 years, the totals for HF were estimated to be $11.5 billion and $9.53 billion, respectively, on an annual basis in 2012; by 2030, these numbers could jump to $29.9 billion and $25.6 billion.¹

According to the American Heart Association, “Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen.”² In a recent study published in JAMA Cardiology, investigators from Kaiser Permanente Northern California sought to understand the connection between an aging population and the “epidemic of deaths due to heart failure underway in the US.”³

Based on data gleaned from the CDC’s Wide-Ranging Online Data for Epidemiologic Research data set, during the study period of January 1, 2011, through December 31, 2017, the Kaiser team discovered that the rate of mortality from heart disease slowed by 5% among adults 65 and older, but that 80% of deaths due to heart disease occurred in this patient population. Simultaneously, the age-adjusted mortality rates increased for HF as the underlying cause by 20.7% and 8.1% as a contributing cause, which equates to a 38% increase in the number of deaths from HF.⁴

Lead study author Stephen Sidney, MD, MPH, senior researcher with the Kaiser Permanente Northern California Division of Research, noted, “The United States is now experiencing a dramatic increase in the number of older people dying from heart disease, and especially heart failure.” Unfortunately, this follows a sizeable decrease in deaths from heart disease between 2000 and 2011. On a similar note, total deaths from HF as both a contributing and underlying cause fell between 2000 and 2009, before steadily increase through 2017.

With the older-than-65 population expected to experience another significant increase in size—a 44% jump by 2030—the burden on public health and prevention and management of heart disease by will be a challenge.⁴ According to the study authors, “Innovative and effective approaches for surveillance, prevention, and treatment are needed to address the expanding burden of HD mortality, particularly for the substantially increasing rates of HF.”

To avert substantial implications on public health and medical care, this means innovation at both the patient and health care system levels, according to senior author Jamal S. Rana, MD, PhD, chief of cardiology as the Kaiser Permanente Division of Research⁴; implementing strategies to prevent HF, and making healthcare more efficient.¹

References

1. Heidenreich PA, Albert NM, Allen LA, et al; American Heart Association Advocacy Coordinating Committee; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Clinical Cardiology; Counctil on Epidemiology and Prevention; Stroke Council. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606-619. doi: 10.1161/HHF.0b013e318291329a.

2. American Heart Association. What is heart failure? AHA website. heart.org/en/health-topics/heart-failure/what-is-heart-failure. Updated May 31, 2017.

3. Epidemic of death dues to heart failure underway in US [press release]/ Rockville, MD: Kaiser Permanente; November 1, 2019. sciencedaily.com/releases/2019/11/191101143949.htm. Accessed November 4, 2019.

4. Sidney S, Go AS, Jaffe MG, Solomon MD, Ambrosy AP, Rana JS. Association between aging of the US population and heart disease mortality from 2011 to 2017 [published online October 30, 2019]. JAMA Cardiol. doi: 10.1001/jamacardio.2019.4187.