Black Adults Face Heart Failure Hospitalization Years Earlier Than White Counterparts

A new study published by investigators from Northwestern Medicine in the Journal of the American College of Cardiology reveals that Black adults in the U.S. are first hospitalized for heart failure (HF) nearly 14 years earlier than White adults, with disparities also visible in Hispanic and Asian populations.

The insights, garnered from an analysis of over 40,000 hospitalized patients across the country, found that these disparities were linked to socioeconomic factors including insurance coverage and education levels in their communities.^1,2

Heart Failure Disparities Along Racial and Ethnic Lines

HF is a leading killer in the US and worldwide, and its impact is only expected to grow in coming decades. The burden varies across racial and ethnic lines, as underrepresented groups face considerable disparities in HF, including a higher incidence and earlier onset.

Research also shows that place-based differences in the burden of HF are prevalent, with heightened mortality in southern states, rural areas, and communities with greater deprivation. It is critical to elucidate specific ages that patients in minority communities may experience HF compared with other demographic groups.^1,3

A group of investigators used the Get With the Guidelines—Heart Failure (GWTG-HF, 2016–2019) registry to determine the age of individuals at first HF hospitalization across various racial and ethnic groups. They also looked at relevant and relative social risk factors that contribute to the differences the results. Such determinations can aid policymakers and health care providers as they work together to craft practical solutions and bridge gaps across communities.¹

Registry Analysis Finds Decade-Plus Difference in HF Onset Between Black and White Patients

The study looked at patients in the registry with no prior diagnosis of HF and assessed the age at first HF hospitalization in non-Hispanic (NH) Asian, NH Black, Hispanic, and NH White adults. Oaxaca-Blinder decomposition was utilized to estimate the proportion of ethnic and racial differences across clinical and social factors associated with age at first HF hospitalization. In total, 42,252 patients with first captured HF hospitalization were identified in GWTG-HG, with 2% self-identifying as NH Asian, 24% as NH Black, 7% as Hispanic, and 67% as NH White.¹

Individuals who were NH Black, Hispanic, and NH Asian were significantly younger than NH White patients at the time of their first HF hospitalization (60.1, 65.4, and 70.6 years vs 73.6 years; P < .01). Variations in clinical and social risk factors across demographic groups were meaningfully associated with younger age at first HF hospitalization for NH Black, Hispanic, and NH Asian patients by 12.5, 7.4, and 1.2 years, respectively, compared with NH White patients, according to the study authors.¹

How to Close Gaps in Treatment and Diagnosis

Beyond increased medical treatment capacity (especially through opening up more health care and cardiologist facilities in underserved areas), raising awareness and advocating for policies that allows equal access to economic and educational opportunities, healthy food, and affordable, high-quality health care is a critical step to take based on this data, according to Xiaoning Huang, MD, research assistant professor of cardiology at Northwestern University Feinberg School of Medicine and first author on the study.^1,2

“Our study shows that social risk factors, including insurance status and area-level educational and economic opportunities, played a major role. These factors often limit people’s access to quality health care and shape people’s health long before they develop heart problems,” Huang explained. “These are striking differences, especially for Black patients.”²

Health systems and pharmacists must remain aware of the earlier onset of HF in marginalized communities and prioritize heart screenings and thorough patient counseling in these individuals. Preventive strategies, including smoking cessation, exercise, and healthy eating, should be encouraged early on. Simultaneously, pharmacists and health care professionals must be careful to build a trustworthy relationship with their patients, given the long history of medical distrust and exploitation among racial and ethnic groups.²

Pharmacists play an integral role in connecting at-risk patients to applicable resources that can assist in addressing both medical and social needs, as these issues are becoming increasingly intertwined, especially in HF.²

REFERENCES

1. Huang X, Hughes Z, Fonarow GC, et al. Racial and Ethnic Differences in Patient Age at First Hospitalization for Heart Failure. JACC Journals. 2025;86(10):711-720. doi:10.1016/j.jacc.2025.06.046

2. Northwestern University. Black adults face heart failure nearly 14 years earlier than white patients. EurekAlert! News Release. Released September 1, 2025. Accessed September 17, 2025. https://www.eurekalert.org/news-releases/1096177

3. Khan SS, Breathett K, Braun LT, et al. Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2025;151(20). doi:10.1161/CIR.0000000000001307