This research, led by Matthew Dupre, Scott Lynch, Jessica West, and Hanzhang Xu, offers a comprehensive look at the complex factors that influence the lives and hospital stays of people living with heart failure (HF) and cardiovascular disease. Their work moves beyond simple clinical checklists to examine how a person’s neighborhood, race, sensory health, and even their own intuition can predict their long-term health journey.
The authors find that the neighborhood a patient calls home plays a significant role in their health long after an initial diagnosis. While medical care at the time of diagnosis is crucial, patients living in socioeconomically disadvantaged neighborhoods face a much higher risk of recurrent hospitalizations over the following eight years. These neighborhood-level disparities often mean patients have less access to the medical, logistical, and social support networks required to manage a complex, chronic condition like heart failure.
By following patients for up to five years, the authors identify four distinct "trajectories" or patterns of hospital use, ranging from a "low risk" group to a "consistently high risk" group. Their findings highlight a stark reality: non-Hispanic Black patients are significantly more likely to experience early, late, or consistently high risks of being hospitalized compared to White patients. Much of this excess risk is driven by co-existing conditions like diabetes and kidney disease, as well as the challenges of living in disadvantaged areas.
A person's ability to communicate effectively with their medical team is vital for managing heart failure, which requires following a strict regimen of medications and lifestyle changes. The research reveals that heart failure patients with untreated hearing loss are hospitalized significantly more often than those with normal hearing. Crucially, when patients used hearing aids, their risk of hospitalization drops to levels nearly identical to those with normal hearing. This suggests that simple interventions to improve communication can be a powerful tool in preventing unnecessary hospital stays.
Finally, the research emphasizes that patients often have the best sense of their own health. In a study of patients being discharged after heart surgery or treatment, nearly one-third felt they were at high risk of returning to the hospital within a month. Those who perceived a high risk were indeed significantly more likely to be readmitted. This "self-awareness" is often based on the patient's past experiences and their daily struggle with symptoms, providing a valuable clinical insight that standard medical tests might miss.
Together, these studies demonstrate that improving outcomes for heart failure patients requires looking at the "whole person". By accounting for social factors, improving communication, and listening to patient concerns, healthcare providers can better identify those at risk and provide more personalized, effective care.
Citations
Dhingra, Radha; Xu, Hanzhang; Hammill, Bradley G.; Lynch, Scott M.; West, Jessica S.; Green, Michael D.; Peterson, Eric D.; Curtis, Lesley H.; Dupre, Matthew E. (2024). Association Between Socioeconomic Disadvantage and Risks of Early and Recurrent Admissions Among Patients With Newly Diagnosed Heart Failure. Circulation: Cardiovascular Quality and Outcomes. https://doi.org/10.1161/CIRCOUTCOMES.124.011141
Dupre, Matthew E.; Dhingra, Radha; Xu, Hanzhang; Hammill, Bradley G.; Lynch, Scott M.; West, Jessica S.; Green, Michael D.; Lesley H. Curtis; Peterson, Eric D. (2025). Racial and ethnic disparities in longitudinal trajectories of hospitalizations in patients diagnosed with heart failure. American Heart Journal. https://doi.org/10.1016/j.ahj.2025.04.006
West, Jessica S.; Xu, Hanzhang; Francis, Howard W.; Smith, Sherri L.; Dupre, Matthew E. (2026). The Impact of Hearing Loss on Hospitalizations Among US Adults with Heart Failure. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-10107-6
Xu, Hanzhang; Farmer, Heather R.; Granger, Bradi B.; Thomas, Kevin L.; Peterson, Eric D.; Dupre, Matthew E. (2021). Perceived Versus Actual Risks of 30-Day Readmission in Patients With Cardiovascular Disease. Circulation: Cardiovascular Quality and Outcomes. https://doi.org/10.1161/CIRCOUTCOMES.120.006586