Epidemiology of Heart Failure in a Universal Healthcare system

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We conducted a cross-sectional study of MHS beneficiaries aged 18 to 64 years to measure the prevalence of HF stages in 2018-19 and evaluate disparities by sex, race, and other sociodemographic characteristics. We defined HF stages defined as preclinical HF (Stage A or B) or clinical HF (stages C/D). Clinical HF was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Among 6,375,086 MHS beneficiaries aged 18 to 64 years, the prevalence of both preclinical and clinical HF was remarkably high (18% and 2.5%). Persons with preclinical HF were mainly middle aged with similar proportions of men and women. Persons with HF were slightly older, mainly men, retired from military service, of enlisted rank (proxy for lower socio-economic status). Male sex, older age, black race, and lower rank were univariately associated with higher relative odds of both preclinical and clinical HF. After multivariable adjustment, male sex, black race and lower rank were independently associated with large increases in prevalent HF. All stages of HF are highly prevalent among MHS beneficiaries of working age. The high prevalence of preclinical HF particularly noticeable among Black beneficiaries delineates critical avenues for prevention. The large excess odds of HF among Black beneficiaries and among individuals with lower socio-economic status underscore the urgent need for further research to understand and address the determinants of these disparities. Published abstract Roger VL, Banaag A, Korona-Bailey J, Turner C, Haigney MC, Koehlmoos TP. Heart Failure In A Universally Insured Working Age Population: The Military Community Experience. Circulation. 2022;145(Suppl_1).