Abstract Body (Do not enter title and authors here): Background:
Heart failure is a growing public health concern in the United States, with a steadily increasing prevalence. It affects approximately 1.9% to 2.6% of adults overall and 8.0% to 9.1% of adults aged 65 and older. Risk is influenced by age, sex, race, and socioeconomic status. As the population ages and chronic conditions such as hypertension, diabetes, and obesity rise, the burden on healthcare systems is expected to increase. Understanding demographic and geographic patterns is essential for designing effective prevention and intervention strategies.
Objective:
This study aims to build on prior research by conducting over a decade-long trend analysis using data from NHANES (2008-2020) and the National Inpatient Sample (NIS). We examine the rising prevalence of heart failure across demographic groups and U.S. regions.
Methods:
We analyzed data from the NHANES and National Inpatient Sample (NIS) from 2008 to 2020. The NIS is the largest all-payer inpatient care database in the U.S., covering 20% of discharges from non-federal hospitals. Heart failure mortality trends were evaluated across sex, race, age, and region.
Results:
Over the 13-year period, heart failure prevalence rose significantly among males (p<0.0001) and females (p<0.00017), with a more pronounced increase in females. Significant increases were found across all racial/ethnic groups: Non-Hispanic Whites, Non-Hispanic African Americans, Hispanics, Asians, Native Americans, and others (p<0.0001, <0.0001, <0.0001, <0.0001, <0.01, and <0.0005), with Non-Hispanic Whites most affected. All age groups—18–25, 26–40, 41–64, and 65+—showed significant increases (all p<0.0001), with the 41–64 group showing the largest rise. Regionally, all U.S. areas—Northeast, Midwest, South, and West—experienced significant increases (all p<0.0001), with the South showing the most notable growth. In total, 59,663,227 patients were diagnosed with heart failure; 56,672,636 survived, while 2,990,591 died.
Conclusion:
Heart failure mortality has risen significantly across all demographic and regional groups over the past decade. The highest increases occurred among Non-Hispanic White males aged 41+ and in the Southern U.S. These findings highlight the urgent need for targeted public health strategies, early detection, and equitable access to care