Characteristics and Treatment of Prevalent Heart Failure in the US: A Cross-Sectional Analysis of Annual Trends From 2014-2023
Author(s)
Zihe Zheng, PhD1, June Fung, MA2, Arvind Katta, PharmD1, Sonia Gomez, PhD3, Sascha van Boemmel-Wegmann, PhD2, alex hartenstein, MD, MA4, Charlie Scott, MSc1, Simone Heeg, PhD2, Katja Rohwedder, MD2, Alanna Morris, MD5, Rachel Knapp, MPA2.
1Bayer US LLC, Whippany, NJ, USA, 2Bayer AG, Berlin, Germany, 3Syneos Health, Madrid, Spain, 4Bayer, Berlin, Germany, 5Bayer AG, Whippany, NJ, USA.
1Bayer US LLC, Whippany, NJ, USA, 2Bayer AG, Berlin, Germany, 3Syneos Health, Madrid, Spain, 4Bayer, Berlin, Germany, 5Bayer AG, Whippany, NJ, USA.
OBJECTIVES: The global burden of heart failure (HF) is growing, given an ageing and highly comorbid population. While some disease-modifying agents have been used to treat HF with reduced ejection fraction (HFrEF) for decades, others including sodium-glucose cotransporter-2 inhibitors (SGLT2i) and angiotensin receptor/neprilysin inhibitor (ARNi) were introduced for use in HFrEF and HF with mildly reduced and preserved EF (HFmrEF/ HFpEF) more recently. Our study describes the characteristics, comorbidity profile and treatment of prevalent HF patients over time from 2014-2023.
METHODS: We performed a cross-sectional analysis of Optum® de-identified Electronic Health Records from 2014-2023, using a combination of ICD-9-CM/ICD-10-CM diagnoses, NLP-extracted EF measurements, NDC and HCPCS/CPT-4/ICD-9-PCS procedure codes. Patients were identified for inclusion in annual cohorts if they were ≥18 years of age on January 1 and had ≥1 HF diagnosis and ≥1 EF value (from 5-95%) during the respective year. Sociodemographic characteristics, comorbidities and treatment were reported for all HF patients and EF sub-cohorts (HFrEF: EF≤40%; HFmrEF: 41-49%; HFpEF: EF≥ 50%).
RESULTS: The share of patients with HFmrEF (2014: 12.6%; 2023: 14.8%) and HFpEF (2014: 52.0%; 2023: 56.5%) increased over time, while HFrEF decreased (2014: 37.5%; 2023: 30.2%). More than half of HF patients had chronic kidney disease (61.3-64.6%) and one-third had Type 2 diabetes (35.4-37.3%), with higher levels reported in HFpEF than in HFrEF and HFmrEF. Common comorbidities included hypertension (87.7-90.7%), dyslipidemia (69.3-74.7%), coronary artery disease (69.0-75.2%), and anemia (57.9-65.4%). Following recent approvals, SGLT2i prescriptions rose from <3% in 2020 to 18.7% in 2023. Strong differences in prescribing SGLT2i (HFrEF: 30.5%, HFmrEF: 19.5%, HFpEF: 12.3%) and ARNi (HFrEF: 34.4%, HFmrEF: 18.4%, HFpEF: 4.9%) were reported across subtypes in 2023.
CONCLUSIONS: Despite stable increases in the prevalence of HFmrEF/HFpEF, the use of novel treatments in these patients remains low. Further research is warranted to drivers of low uptake.
METHODS: We performed a cross-sectional analysis of Optum® de-identified Electronic Health Records from 2014-2023, using a combination of ICD-9-CM/ICD-10-CM diagnoses, NLP-extracted EF measurements, NDC and HCPCS/CPT-4/ICD-9-PCS procedure codes. Patients were identified for inclusion in annual cohorts if they were ≥18 years of age on January 1 and had ≥1 HF diagnosis and ≥1 EF value (from 5-95%) during the respective year. Sociodemographic characteristics, comorbidities and treatment were reported for all HF patients and EF sub-cohorts (HFrEF: EF≤40%; HFmrEF: 41-49%; HFpEF: EF≥ 50%).
RESULTS: The share of patients with HFmrEF (2014: 12.6%; 2023: 14.8%) and HFpEF (2014: 52.0%; 2023: 56.5%) increased over time, while HFrEF decreased (2014: 37.5%; 2023: 30.2%). More than half of HF patients had chronic kidney disease (61.3-64.6%) and one-third had Type 2 diabetes (35.4-37.3%), with higher levels reported in HFpEF than in HFrEF and HFmrEF. Common comorbidities included hypertension (87.7-90.7%), dyslipidemia (69.3-74.7%), coronary artery disease (69.0-75.2%), and anemia (57.9-65.4%). Following recent approvals, SGLT2i prescriptions rose from <3% in 2020 to 18.7% in 2023. Strong differences in prescribing SGLT2i (HFrEF: 30.5%, HFmrEF: 19.5%, HFpEF: 12.3%) and ARNi (HFrEF: 34.4%, HFmrEF: 18.4%, HFpEF: 4.9%) were reported across subtypes in 2023.
CONCLUSIONS: Despite stable increases in the prevalence of HFmrEF/HFpEF, the use of novel treatments in these patients remains low. Further research is warranted to drivers of low uptake.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD22
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)