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The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a \u03b2-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upper\u2013middle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lower\u2013middle-income countries (39.5%) (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upper\u2013middle-income countries, 15.7 (95% CI, 15.0-16.4) in lower\u2013middle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratio\u2009=\u20093.8) and in upper\u2013middle-income countries (ratio\u2009=\u20092.4), similar in lower\u2013middle-income countries (ratio\u2009=\u20091.1), and less frequent in low-income countries (ratio\u2009=\u20090.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upper\u2013middle-income countries (9.7%), then lower\u2013middle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lower\u2013middle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies.<\/jats:p><\/jats:sec><jats:sec id=\"ab-joi230044-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2023.5942","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T15:06:40Z","timestamp":1684249600000},"page":"1650","source":"Crossref","is-referenced-by-count":182,"title":["Global Variations in Heart Failure Etiology, Management, and Outcomes"],"prefix":"10.1001","volume":"329","author":[{"name":"G-CHF Investigators","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariela","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Prado","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Hominal","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar J.","family":"Zaidman","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Cursack","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"MacKinnon","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Zapata","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Rojas","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben G.","family":"Duran","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar G.","family":"Vilamajo","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar P.","family":"Dutra","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00edvia","family":"Oliveira","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Pavanello","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Minelli","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sousa","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia N.","family":"Maia","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro E.","family":"Hernandes","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00facio","family":"Oliveira","sequence":"additional","affiliation":[{"name":"G-CHF Investigators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weimar K. 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