Decline in heart failure deaths has been undone, led by people under 45

https://www.statnews.com/2024/04/24/heart-failure-deaths-decline-undone/

by gulced • 2 years ago

36 32 2 years ago

This is just risk compensation playing out. The better resources the environment has, the more we will eat until we kill ourselves.

steego• 2 years ago

So you’re asserting that people are engaging in riskier behavior because they feel safer?

I don’t want to put words in your mouth, I’d like for you to expand on your two sentences.

mensetmanusman2• 2 years ago

Yeah, https://en.m.wikipedia.org/wiki/Risk_compensation

There are lots of analogs. At a population scale it seems reasonable.

giantg2• 2 years ago

I wonder to what degree drug related heart failure has affected the numbers.

CryptoBanker• 2 years ago

That would be my guess. More drugs, less exercise, and less sleep than generations before

alecst• 2 years ago

Do we know what these young heart failure patients look like in the typical case? Are they obese? Stressed? A mix?

Funes-• 2 years ago

Were they vaccinated against COVID? Did they get infected at any point?

ekianjo2• 2 years ago

good questions but you will never get any clear answer on that because there is too much at stake.

refurb2• 2 years ago

and accelerated upward once the Covid-19 pandemic arrived...The greatest reversals were seen in those aged younger than 45

thorum2• 2 years ago

I found the graphs in the original linked article pretty helpful in understanding the trend.

https://cdn.jamanetwork.com/ama/content_public/journal/cardi...

benterix• 2 years ago

What's the reason for Hispanic being much better than Black and White? Is it a more relaxed lifestyle? Maybe not, as "Non-Hispanic Other" would probably indicate Asians so it's hard for me to grasp the reason for such a large difference.

silverquiet• 2 years ago

Millennials are also dying of cancer at increased rates compared to previous generations. I think obesity is the most obvious suspect, but one does wonder about environmental issues as well.

486sx33• 2 years ago

Obviously from covid vaccine damage

pedalpete2• 2 years ago

Though the article (and one of the comments here) is suggesting Covid could be the source, I don't think we should discount the impact of simple lockdowns and work from home could have on exercise rates, and potentially diet as well.

Of course, Covid itself also increased mortality in an already vulnerable population.

Basically, we need more data past 2021 to understand the trend.

nytesky• 2 years ago

Commuting has long been known to be detrimental to health.

Exercise may have ticked up since walking became much more common. People were “locked down” at least in the US for like a bad winter season.

Maybe diet was a problem (too much sourdough carbs)

But if it’s not COVID, I would look at isolation. Perhaps the young deaths were especially isolated, and we have all suffered from the epidemic of loneliness over the last half decade.

xboxnolifes• 2 years ago

Commuting has long been known to be detrimental to health.

Commuting that isn't walking/biking.*

joegibbs• 2 years ago

There's a jump in Covid times but you can see on the graph that it started around 2011, which is about the same time US life expectancy started stagnating. It's interesting that Australia has a life expectancy of 83 years, 7 years more than America (before Covid this was 4 years, and I expect America to bounce back up because it affected elderly people more).

Australians are only 4% less obese and 4% less overweight than Americans. However the percentage of Australians that are morbidly obese (BMI over 35) is 9.4%, and for Americans that's 18% - so the obese people in America are more likely to be really obese. Alternatively it could be to do with Americans being less likely to go to the doctor or have operations done due to higher healthcare costs.

pedalpete2• 2 years ago

I live in Australia!! Though I'm from Canada originally.

When I first started travelling to Australia in 2000, I was amazed by how small all the food was. Plates where tiny, drinks were 1/3 the size of North American (except beer).

Australia has caught up, and serving sizes have increased to near North American sizes. I wonder what affect this will have on Australian life expectancy in the next decade.

refurb2• 2 years ago

Under 45?

Heart failure is exceedingly rare.

Heart failure is not the same as coronary artery disease (I.e. what people typically think of when they think of people who get heart attacks). While it can be related.

Hypertension, diabetes, etc can all contribute to heart failure.

thefz• 2 years ago

Working from home has led me to exercise way more than before, as I have 2+ hours free daily thanks to not having to commute.

lispisok• 2 years ago

Study cited here [1]. The inflection point was around 2013 then accelerated in 2020.

[1] https://jamanetwork.com/journals/jamacardiology/fullarticle/...

tflinton2• 2 years ago

I’m fairly confused by some comments here claiming Covid or vaccines were the cause as the article clearly points out the uptick in deaths started in 2012.

I tend to think it might be the uptick in use of amphetamines. Millineials and late genx were the first to use them in wide scale with a 2.5 increase and a second derivative maxima in 2012, the same time heart failures began dramatically increasing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/

thorum2• 2 years ago

The increase from 2019-2021 (+2 years) was higher than the increase from 2012-2019 (+7 years). I wouldn't want to make any specific claims about the cause, but clearly the pandemic or the response to the pandemic was involved somehow.

tflinton2• 2 years ago

Not necessarily. The CDC reported a sharp increase of stimulant prescriptions at the same time. Adjusted for population it’s not as dramatic as 2012 but still. Amphetamines are incredibly dangerous and cause heart failure and were being prescribed at an alarming rate until the last year.

https://www.cdc.gov/mmwr/volumes/72/wr/mm7213a1.htm

heyoni4• 2 years ago

Amphetamine usage steadily increased over decades while heart failure rates were decreasing. The article itself suggests that maybe opioid overdoses are being marked as heart failure rather than cardiac arrest which would make way more sense considering how relatively rare amphetamine overdoses are.

zcw100• 2 years ago

It's an unnecessarily inflammatory title. It seems to imply that we were making progress until those damn millennials screwed it up and undid it. Also "undid" seems to imply some deliberate action.

Also from the article.

"Yancy sees three explanations for higher death rates from heart failure: First, the persistence of risk factors and the necessity to intervene there. “That’s actionable,” he said. Second, the persistence of health inequities. “That is theoretically actionable, but it will require as much public policy as it will require medical therapeutics and lifestyle change.” Third is the outsized influence of Covid-19, a phenomenon he said we have yet to understand."

So why are risk factors and interventions "actionable" but health inequities only "theoretically actionable"? There's also a direct connection and large overlap between health inequities and lack of interventions so the first and second are almost the same thing. The influence of covid-19 was the most interesting but they just shrugged and said, "We don't really know much bout that".

What's hard to understand here? Older generations are showering themselves with money to wash away their problems while the younger generation is poor and suffer from unaddressed health issues.

Decline in heart failure deaths has been undone, led by people under 45

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