Abstract 4365870: Projected Widening of Racial and Geographic Disparities in Heart Failure Mortality Among US Older Adults by 2040

Introduction: Heart failure (HF) is a leading cause of death, hospitalization, and disability among older adults (≥75 years), a population experiencing rapid growth and disproportionate HF burden. While current disparities in HF mortality by sex, race, and geography are documented, long-term forecasts of age-adjusted mortality rates (AAMR) and the evolution of these critical disparities are absent. This study utilized comprehensive national data from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research(CDC WONDER) (1999-2023) to forecast HF AAMR trends through 2040, specifically evaluating the future trajectory of sex, racial (White/Black), and geographic (metropolitan/non-metropolitan) disparities within this increasingly vulnerable US population. Methods: We retrieved age-adjusted mortality rates (AAMR) for adults ≥75 years with heart failure (ICD-10: I11.0, I13.0-I13.2, I50.0, I50.1, I50.9) from 1999- to 2023 using CDC WONDER.An ARIMA(Autoregressive Integrated Moving Average) model ,using Python 3, was constructed and utilized to forecast trends through 2040 with 95% CIs. Subgroup analyses by sex, race (White/Black), and metropolitan status (metro/non-metro) were conducted. Results: Forecasts predict an overall AAMR increase from 135.59 (2024) to 139.66 (2040; Δ+4.07). Gender disparities show rising female rates (120.28→125.05; Δ+4.77) versus stable male trends (AAMR:156.26→157.77; Δ+1.51), narrowing the AAMR gap from 36.0 to 32.7 points. Non-metro areas demonstrate steeper increases (AAMR:169.63→192.59 by 2037; Δ+22.96) versus metro (AAMR:135.02→154.96; Δ+19.94), widening the geographic AAMR gap from 34.61 to 37.63. Racial disparities intensify with White mortality rising steadily (AAMR:148.99→156.20; Δ+7.21) while Black rates plateau (AAMR:122.99→123.77; Δ+0.77), expanding the racial gap from 26.0 to 32.4 points by 2040. Conclusion: Significant demographic disparities in heart failure mortality are projected to persist or widen, necessitating equity-focused public health strategies for vulnerable elderly populations. Disclosure: This abstract was refined using automated writing tools (AI) for grammatical enhancement and readability only. All research data, analysis, and conclusions are original to the authors, who take full responsibility for the content’s accuracy and originality.