Heart Failure Risk Much Higher in Rural Areas
WASHINGTON — Adults living in rural areas of the United States have a 19% higher risk of developing heart failure compared with their urban counterparts, according to a study supported by the National Institutes of Health.
The news is worse for Black men living in rural areas. In the case of that population, the risk rose to 34% higher than their urban counterparts.
The findings were published Wednesday in JAMA Cardiology.
The study is one of the first to look at the link between living in rural America and first-time cases of heart failure, and the findings came as something of a surprise.
“We did not expect to find a difference of this magnitude in heart failure among rural communities compared to urban communities, especially among rural-dwelling Black men,” said Véronique L. Roger, M.D., M.P.H., the study’s corresponding author, in a written statement.
She and her fellow researchers say their findings underscore the importance of developing more customized approaches to heart failure prevention in rural communities, particularly for Black men.
“It is much easier to prevent heart failure than to reduce its mortality once you have it,” said study co-author Sarah Turecamo, a fourth-year medical student at New York University Grossman School of Medicine in New York City.
During the study, researchers from the National Heart, Lung, and Blood Institute, part of NIH, and Vanderbilt University Medical Center in Nashville, Tennessee, analyzed data from the Southern Community Cohort Study, a long-term health study of adults in the southeastern United States.
They compared the rates of new onset heart failure among rural and urban residents in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia).
The population, which included 27,115 adults without heart failure at enrollment, was followed for about 13 years.
Nearly 20% of participants lived in rural areas; the remainder lived in urban areas. Almost 69% were Black adults recruited from community health centers that care for medically underserved populations.
In addition to the findings highlighted above, the study showed White women living in rural areas had a 22% increased risk of heart failure compared with White women in urban areas, and Black women had an 18% higher risk compared with Black women in urban areas. No association was found between rural living and heart failure risk among White men.
The exact reasons behind these rural-urban health disparities are unclear and are still being explored. Researchers said a multitude of factors may be at play, including structural racism, inequities in access to health care, and a dearth of grocery stores that provide affordable and healthy foods, among others.
Heart failure is a chronic and progressive condition that develops when the heart does not pump enough blood for the body’s needs. Common symptoms include shortness of breath during daily activities or trouble breathing when lying down. The condition, which has few treatment options, affects about 6.2 million American adults.
The study was largely funded by the National Heart, Lung, and Blood Institute. Turecamo is part of the NIH Medical Research Scholars Program.
Dan can be reached at [email protected] and @DanMcCue
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