American Heart Association, Nov. 16-18

The annual meeting of the American Heart Association was held this year from Nov. 16 to 18 in Chicago, drawing attendees from around the world, including cardiovascular specialists, surgeons, and nurses as well as other health care professionals. The conference featured presentations focusing on the latest advances in cardiovascular medicine and surgery.

In one study, Lucas X. Marinacci, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues found that cardiovascular mortality increased among rural areas and decreased among urban areas between 2010 and 2022, leading to a widening of rural-urban disparities in cardiovascular death rates.

Pulling information from the U.S. Centers for Disease Control and Prevention WONDER database, national mortality data for more than 11 million adults between 2010 and 2022 were evaluated.

The researchers observed an increase in cardiovascular mortality nationwide after the pandemic, which disproportionately impacted rural areas. In addition, there was notably a concerning rise in cardiovascular mortality among younger (25 to 64 years) rural adults before the pandemic that then accelerated in its wake. Furthermore, differences in poverty, education, and insurance coverage accounted for a substantial portion of rural-urban differences in cardiovascular mortality as of 2022.

“One key takeaway is that targeted policy efforts are needed to address rising cardiovascular mortality in rural areas, especially among younger age groups,” Marinacci said. “This can include initiatives to increase insurance coverage, such as by expanding Medicaid under the Affordable Care Act in states that have yet to do so; improving health care access, such as by preventing hospital closures; bolstering the rural health care workforce and expanding telemedicine reimbursement; addressing the surge in severe obesity and its downstream cardiometabolic consequences through concerted public health campaigns; and, finally, addressing the underlying socioeconomic determinants of health — including educational attainment and poverty — that are strongly linked to adverse cardiovascular outcomes.”

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In another study, M. Ali Sheffeh, M.D., of the Mayo Clinic in Rochester, Minnesota, and colleagues found that patients with a previous stroke who are prescribed either a glucagon-like peptide-1 (GLP-1) receptor agonist or a sodium-glucose cotransporter 2 (SGLT2) inhibitor have a reduced risk for a heart attack, second stroke, and death.

The authors conducted a retrospective study between 2000 and 2022 and included all patients who had a stroke in parts of Minnesota and Wisconsin. The effect of using these two different diabetes medications (SGLT2i and GLP-1 RA) on the risk for death or having a future heart attack or another stroke was then evaluated. The researchers discovered that patients who took one of these medications had a lower risk for death or experiencing a heart attack or another stroke.