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January 10, 2025 — A recent study published in the European Journal of Heart Failure has shed light on significant geographic differences in the characteristics, treatment, and outcomes of patients with heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF). The study, which analyzed data from 19,959 patients across five global regions, highlights the diverse challenges and health profiles faced by individuals with heart failure worldwide.
Key Findings
The study revealed striking variations in patient demographics and associated health conditions:
- Western Europe: Patients tended to be older compared to other regions.
- Central/Eastern Europe and Russia: Patients were younger, with higher rates of hypertension and coronary heart disease.
- Latin America: This region reported the highest proportion of female patients.
- North America: Patients were notable for the highest prevalence of obesity and diabetes and included the largest percentage of Black patients.
- Asia-Pacific: Patients here reported the best self-perceived health status among the five regions studied.
The differences extended to outcomes as well. Rates of cardiovascular death or heart failure hospitalization—the primary composite endpoint—varied significantly by region.
Regional Heart Failure Outcomes
For patients with HFmrEF, the composite endpoint rates (per 100 patient-years) were:
- North America: 12.56
- Asia-Pacific: 11.67
- Central/Eastern Europe and Russia: 10.12
- Latin America: 8.90
- Western Europe: 8.43
Among those with HFpEF, the rates were:
- North America: 11.47
- Asia-Pacific: 7.80
- Central/Eastern Europe and Russia: 5.47
- Latin America: 5.92
- Western Europe: 7.80
The study noted that variations in heart failure hospitalization rates were the primary drivers of these differences.
Implications for Care
The findings underscore the importance of tailoring heart failure management strategies to regional health profiles and resource availability. For example, the high prevalence of obesity and diabetes in North America may necessitate more aggressive metabolic management, while addressing hypertension and coronary heart disease in Central/Eastern Europe and Russia could improve outcomes.
The study also emphasizes the need for further research into the social, economic, and healthcare system factors contributing to these variations. Understanding these disparities can help shape more equitable and effective treatment approaches for heart failure patients worldwide.
As heart failure remains a leading cause of morbidity and mortality globally, these insights could play a vital role in improving care and reducing disparities in outcomes across regions.
