Heart failure & cardiomyopathies

Sex differences in the etiology and burden of heart failure across country income level: analysis of 204 countries and territories 1990–2019

Eur Heart J Qual Care Clin OutcomesPublished Cross-sectional study

Authors' conclusion

Age-standardized HF rates have decreased over time, with larger decreases in males than females; and with large decreases in high-income and small increases in low-income regions.

Study context

Population
People with heart failure (HF) in 204 countries and territories, 1990–2019people with HF in 2019
Participants
56.2 million people
Exposure
Females vs males; across country income levels
Outcome
Sex differences in HF prevalence, etiology, morbidity and temporal trends across country income level
Follow-up
1990–2019
Methodological detailsGlobal Burden of Disease data, 204 countries and territories, 1990–2019, age-standardized rates
  • Global Burden of Disease data
  • 204 countries and territories
  • 1990–2019
  • Age-standardized rates

Main finding

As reported in the abstract

2019; change 1990–2019
GroupValueAge-standardized rate 1990Age-standardized rate 2019
Malesdecrease in age-standardized rate per 100 000 9.1%864.2785.7
Femalesdecrease in age-standardized rate per 100 000 5.8%686.0646.1

Value

Malesdecrease in age-standardized rate per 100 000 9.1%
Femalesdecrease in age-standardized rate per 100 000 5.8%

Age-standardized rate 1990

Males864.2
Females686.0

Age-standardized rate 2019

Males785.7
Females646.1
People with HF in 2019
56.2 million (95% UI 46.4-67.8 million)
Females among people with HF
50.3%
Living in low- and middle-income countries
69.2%
High-income regions: decrease in age-standardized rates (877.5 to 736.8)
16.0%
Low-income regions: increase in age-standardized rates (612.1 to 636.0), largely consistent across sexes
3.9%

Observational data: associations, not effects.

Further findings

Years lived with disability · 2019

YLDs (95% UI 3.3-7.3 million), distributed equally between sexes
5.1 million

Etiology trends · 1990–2019

Increase in age-standardized HF from hypertensive, rheumatic and calcific aortic valvular heart disease; decrease from ischaemic heart disease, with regional and sex differences

Original publication

Sex differences in the etiology and burden of heart failure across country income level: analysis of 204 countries and territories 1990–2019. Eur Heart J Qual Care Clin Outcomes. Published 28 December 2022. doi:10.1093/ehjqcco/qcac088

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