Cardiovascular Hospitalizations Among Older Adults in the US and Denmark

Area of Science:

• Public Health
• Cardiology
• Health Services Research

Background:

• Cardiovascular disease (CVD) is a leading cause of death in the US.
• International comparisons of CVD burden are limited, especially across different healthcare systems.
• Understanding income-related disparities in CVD is crucial for targeted interventions.

Purpose of the Study:

• To compare cardiovascular hospitalization rates (acute myocardial infarction [MI], heart failure [HF], ischemic stroke) and associated outcomes among adults 65 years or older between the US and Denmark.
• To analyze these rates overall and by income level.
• To assess 30-day all-cause mortality following hospitalization for cardiovascular events.

Main Methods:

• Population-based cross-sectional study utilizing national data from the US (Medicare beneficiaries) and Denmark.
• Study period: January 1, 2021, to January 1, 2022.
• Primary outcomes: Age- and sex-standardized hospitalization rates for MI, HF, ischemic stroke, and 30-day all-cause mortality.

Main Results:

• The US had significantly higher age- and sex-standardized cardiovascular hospitalization rates (RR, 1.50) and 30-day mortality (RR, 1.12) compared to Denmark.
• Higher hospitalization risks in the US were observed for MI (RR, 1.56) and HF (RR, 2.37), while ischemic stroke hospitalizations were lower (RR, 0.90).
• Overall cardiovascular hospitalization rates were more than twofold higher in US low-income adults vs. higher-income adults (RR, 2.38), with smaller disparities in Denmark (RR, 1.45).

Conclusions:

• Cardiovascular hospitalization rates are substantially higher in the US compared to Denmark.
• Significant income-based disparities in cardiovascular hospitalizations exist in both countries, but are markedly greater in the US.
• These findings highlight the need for targeted strategies to address CVD burden and income-related inequities in healthcare.