Abstract 14114: Sex Differences in the Etiology and Burden of Heart Failure Across the Sociodemographic Index: Analysis of 204 Countries and Territories, 1990-2019
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abstract
Background:
Heart failure (HF) is a global epidemic.
Objectives:
We assessed sex differences in HF across country income.
Methods:
Using Global Burden of Disease (GBD) data, we assessed sex differences in HF prevalence, etiology, morbidity, and temporal trends between 1990-2019 across 204 countries and territories and disaggregated results by country income (SDI or gross national income).
Results:
In 2019 there were 56.2 million (95% uncertainty interval [UI] 46.4-67.8 million) HF cases worldwide, with over half in females. HF morbidity was estimated at 5.1 million (95% UI 3.3-7.3 million) years lived with disability, distributed equally between the sexes. Overall, ischemic heart disease was the top cause of HF in males, and hypertensive heart disease the top cause in females. Between 1990-2019, there was an increase in total HF cases, but the age-standardized rate per 100,000 decreased by 7.1%, more so in males (9.1%) than females (5.8%). High-income regions experienced a 16.0% temporal decrease in age-standardized rates, from 877.5 to 736.8 per 100,000, while low-income regions experienced a 3.9% increase, from 612.1 to 636.0 per 100,000. Trend directionality was largely consistent in both sexes. Asia, sub-Saharan Africa, and Middle East experienced a temporal increase in age-standardized HF rates in both sexes, related to increasing ischemic heart disease. Globally, there was an increase in age-standardized HF rates due to calcific aortic valve disease and hypertensive heart disease, and a decrease due to ischemic heart disease, although regional and sex differences were noted.
Conclusions:
Age-standardized HF rates are increasing in the Middle East and low-SDI regions of the world, with sex differences in etiology and trends that offer targets for intervention.
