Trends in mortality attributed to heart failure in Worcester, Massachusetts, 1992 to 2001.

Sparse data are available, particularly from the more generalizable perspective of a population-based investigation, that describe recent trends in community death rates due to heart failure (HF). The objectives of this study were to describe a decade-long trend (1992 to 2001) in mortality attributed to HF among residents of the metropolitan area of Worcester, Massachusetts. A secondary study goal was to describe changes in death rates due to HF in men and in women, in subjects of different ages, and according to location of death. Death data tapes were obtained from the Massachusetts Department of Public Health for greater Worcester residents who died between 1992 and 2001. A total of 2,677 deaths from HF occurred in metropolitan Worcester residents between 1992 and 2001. Increases in crude death rates (per 100,000 population) attributed to HF were observed from 1992 (death rate 82) to 2001 (death rate 102). Adjustment for age attenuated the increase in community death rates due to HF. Slight increases in age-adjusted death rates from HF were noted in men, whereas age-adjusted mortality from HF in women decreased by 22% between our initial study year and the most recent study year. The elderly were at greatest risk for dying of HF and increases in HF death rates were observed in the oldest subjects (>/=85 years of age) over time. There was an increasing proportion of all deaths due to HF that occurred in the out-of-hospital setting in 2001 (61%) compared with 1992 (52%). The results of this study suggest changing patterns in death rates due to HF in a large northeastern community.