#Rural residents consistently have worse CVD outcomes than others. This is 💔 for a KY/TN girl.

Example for #HeartFailure from recent alarming letter from Gregg Fonarow MD looking at hf outcomes. We must improve and help our partners!

jamanetwork.com/journals/jamac…

. #FLOW , one of the most highly anticipated #CKM trials of yr, to be presented #ERA24

Sema 1.0mg once weekly *disease modifying* in CKD+T2D
✅ ↓ Composite kidney events
✅ Slower eGFR decline
✅ ↓ MACE
✅ ↓ All-cause mortality

A new era, firmly establishes 4th pillar in #CKD !

What do you predict for age-adjusted HF-related mortality in 2022, 2023, and 2024?

Reversals in the Decline of Heart Failure Mortality in the US, 1999 to 2021 jamanetwork.com/journals/jamac…

JAMA Cardiology JAMA

Cost effectiveness analysis of 💊 Rx in HFmrEF/HFpEF

Timing of generic pricing is 🔑

Cost-Effectiveness of Medical Therapy for Heart Failure With Mildly Re... sciencedirect.com/science/articl…

Boback Ziaeian 🤦🏻‍♂️ Neal Dixit, MD JACC Journals

Advancing HF stages were associated with increasing risk mortality

Development and implementation of early screening and targeted interventions are urgently needed to reduce HF burdens in China

Prognostic implications of HF stages among Chinese... sciencedirect.com/science/articl…

Heart Failure Mortality Higher Now Than in 1999 dlvr.it/T63y37

We have the tools & know-how to bend this curve ⤵️.

✅ and manage #BloodPressure
✅ and manage blood glucose
🚭 discourage #smoking
🚶‍♀️ encourage & empower active living

Begin preventive screenings and treatments early in life.

American Journal of Preventive Medicine (AJPM) American Journal of Hypertension AJPH

“Recent data suggest plateaus or reversals after long-standing declines in cardiovascular mortality, particularly for HF-related mortality” JAMA Cardiology #Cardiotwitter

Read more👇
healio.com/news/cardiolog…

US heart failure deaths in 2021 reached levels not seen since 1999

healio.com/news/cardiolog…

JAMA Cardiology Marat Fudim, MD MHS Ahmed Sayed Javed Butler

How have HF mortality rates changed from 1999-2021 in the US?

From 1999-2012
↘ : Decline by ~25%

From 2012-2021
↗ Reversals that have now undone ALL initial declines.

🚨HF mortality in 2021 > HF mortality in 1999 🚨

jamanetwork.com/journals/jamac…

Marat Fudim, MD MHS Ahmed Sayed HFSA

Analysis shows that initial declines in HF-related mortality from 1999 to 2012 have been entirely undone by subsequent reversals from 2012 to 2021, meaning that contemporary HF mortality rates are higher than in 1999. ja.ma/3UcwM23

HFrEF ↘️↘️↘️median survival 7-18 years

GDMT ↗️↗️↗️ median survival:

✅ ARNI 2-3 yrs (1-2 yrs vs ACEI or ARB)
✅ BB 3-4 yrs
✅ MRA 2-3 yrs
✅ SGLTi 1-2 yrs

Clinical benefits non-overlapping, incremental, additive

Quadruple >>>triple>>>double

Fast >>>>slow

Now>>>later

Decline in heart failure deaths has been undone, led by people under 45 statnews.com/2024/04/24/hea… via STAT

JAMA Cardiology Clyde Yancy, MD, MSc Marat Fudim, MD MHS Javed Butler Ahmed Sayed

What now❓

⏫ Interventions to prevent HF

⏫ Interventions to treat HF

⏫ Wider & equitable access (potential role for remote patient care?)

❓ Revisit potentially problematic policies

🔬 Revisit impact of pandemic on healthcare

How have HF mortality rates changed from 1999-2021 in the US❓

From 1999-2012📉: Decline by ~25%
From 2012-2021📈: Reversals that have now undone ALL initial declines.

Result: HF mortality in 2021 > HF mortality in 1999 ‼️

Link to our work JAMA Cardiology : jamanetwork.com/journals/jamac…

Why❓

Potential culprits:

1⃣ ⏫ metabolic disease ➡️ ⏫ HF prevalence

2⃣ 🚫care access ➡️ 🚫GDMT ➡️ ⏫ HF mortality

3⃣ HRRP ➡️ bad incentives ➡️ ⏫ HF mortality

4⃣COVID (exacerbating) ➡️ healthcare interruptions +/- 🫀involvement ➡️ ⏫ HF prevalence/mortality