Risk of developing heart failure found to be much higher in rural areas

A team of researchers found adults living in rural areas of the United States face a higher risk of developing heart failure compared to those living in urban spaces. 

Overall, the risk of heart failure was found to be about 19% higher in rural residents.

The study found Black men face the greatest elevated risk — 34%. White women face a 22% increased risk and Black women face an 18% higher risk. 

Heart failure develops when the heart doesn’t pump enough blood for the body’s needs. The condition affects about 6.2 million American adults, according to the Centers for Disease Control and Prevention. It can be prevented by following a heart-healthy lifestyle, though, once developed, is hard to treat.

"It is much easier to prevent heart failure than to reduce its mortality once you have it," study co-author Sarah Turecamo said.

Studying heart failure in rural vs. urban areas

Researchers studied data spanning 13 years from more than 2,700 people in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia).

The data came from The Southern Community Cohort Study, which is a long-term health study of adults in the southeastern U.S. funded by the National Cancer Institute.

"At the end of the study period, the researchers found that living in rural America was associated with an increased risk of heart failure among both women and Black men, even after adjustment for other cardiovascular risk factors and socioeconomic status," a news release for the study explained. 

The study was largely funded by the National Heart, Lung, and Blood Institute (NHLBI), part of National Institutes of Health (NIH). The findings were produced in collaboration with Vanderbilt University Medical Center, Nashville, Tennessee, and were published in JAMA Cardiology

Rural-urban health disparities

Electric poles with many cables located along rural country road with clear blue sky in background. via Getty Images

"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 and a senior investigator with the Epidemiology and Community Health Branch in NHLBI’s Division of Intramural Research. 

"This study makes it clear that we need tools or interventions specifically designed to prevent heart failure in rural populations, particularly among Black men living in these areas."

NIH said the exact reasons behind the risk differences are still unclear and are being researched. 

"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," NIH said. 

Key ways to reduce heart failure risk include avoiding all forms of tobacco, eating healthy, and exercising.

This story was reported from Detroit. 

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