Adults who live in rural areas of the United States are more likely to develop heart failure compared with adults living in urban areas, according to a new study, which also found that Black men living in rural areas are particularly vulnerable.

Adults in rural areas have a 19% higher risk of experiencing first-time cases of heart failure, and Black men living in these areas have a 34% higher risk, according to the observational study supported by the National Heart, Lung, and Blood Institute (NHBLI), part of the National Institutes of Health.

The study underlines the need to explore customized approaches to heart failure prevention in residents of rural areas, especially Black men.

“We did not expect to find a difference of this magnitude in heart failure among rural communities compared to urban communities, especially among rural-dwelling Black men,” said the study’s corresponding author, Véronique L. Roger, MD, MPH, a senior investigator with the Epidemiology and Community Health Branch in NHLBI’s Division of Intramural Research, in an NIH news release. “This study makes it clear that we need tools or interventions specifically designed to prevent heart failure in rural populations, particularly among Black men living in these areas.”

Researchers compared rates of new onset heart failure among rural and urban residents in the Southeast. After tracking 27,115 adults, who did not have heart failure to begin with, for about 13 years, researchers found that the overall risk for heart failure was about 19% higher among rural residents compared with urban residents.

Researchers highlight that Black men living in rural areas were at the highest risk of developing heart failure, at 34%. Black women in rural areas had an 18% higher risk compared with Black women in urban areas. White women in rural areas had a 22% increased risk.

Factors contributing to these disparities, according to researchers, include structural racism, inequitable access to health care and a lack of grocery stores that offer affordable and healthy foods.

“Finding an association between living in rural areas and an increased incidence of heart failure is an important advance, especially given its implications for helping to address geographic-, gender- and race-based disparities,” said David Goff, MD, PhD, director of NHLBI’s Division of Cardiovascular Sciences, in the news release. “We look forward to future studies testing interventions to prevent heart failure in rural populations as we continue to fight heart disease, the leading cause of death in the U.S.”

To learn more, click #Heart Failure, where you’ll find headlines such as “Black Americans Face Disparities in Heart Failure Treatment,” “Asians, Blacks and Latinos Less Likely to Go to Cardiac Rehab,” and “Is Heart Failure More Common Among Women Than Men?”