Racial and Ethnic Differences in Patient Age at First Hospitalization for Heart Failure.

Abstract

The burden of heart failure (HF) varies across racial and ethnic groups. This study characterized the age at first HF hospitalization across racial and ethnic groups and determined the relative contribution of social risk factors to these differences. Patients hospitalized in the Get With The Guidelines-Heart Failure (GWTG-HF, 2016-2019) registry with no prior HF diagnosis were included. Age at first HF hospitalization captured in Get With The Guidelines-Heart Failure (GWTG-HF) was assessed among non-Hispanic (NH) Asian, NH Black, Hispanic, and NH White adults. We used Oaxaca-Blinder decomposition to estimate the proportion of racial and ethnic differences in clinical and social factors associated with age at first HF hospitalization. Among 42,252 patients with first captured HF hospitalization in GWTG-HF, 2% self-identified as NH Asian, 24% as NH Black, 7% as Hispanic, and 67% as NH White. NH Asian, NH Black, and Hispanic patients were significantly younger than NH White patients at time of first HF hospitalization (70.6, 60.1, and 65.4 vs 73.6 years; P < 0.01). Differences in social and clinical risk factors across groups were significantly associated with younger age at first HF hospitalization for NH Asian, NH Black, and Hispanic patients by 1.2, 12.5, and 7.4 years, respectively, compared with NH White patients. NH Asian, NH Black, and Hispanic patients were younger at the time of first HF hospitalization compared with NH White patients in the GWTG-HF registry. Differences in social and clinical factors explained a large proportion of the racial and ethnic differences in age at first HF hospitalization.