HFSA: Nearly 1 in 4 US Adults Will Develop Heart Failure in their Lifetime

Biykem Bozkurt, MD, PhD

Credit: Baylor College of Medicine

Newly released data on heart failure risk in the United States revealed that 1 in 4 individuals are projected to develop heart failure in their lifetime, an increase from the previous projection of 1 in 5 individuals.¹

Announced by the Heart Failure Society of America, the new initiative, HF Stats SM, suggests the estimate is consistent with data indicating approximately 8.5 million people in the US will be impacted by heart failure by 2030.

“As providers, we are all doing our best to take care of our patients living with heart failure, but it’s clear that more work needs to be done on early prevention, recognition, and treatment of our patients to reduce mortality and rehospitalizations,” said Biykem Bozkurt, MD, PhD, of Baylor College of Medicine and the chair of the Data in Heart Failure Committee.²

As part of the initiative, the Data in Heart Failure Committee revealed key findings that paint a current picture of the status of heart failure prevalence, its risk, and mortality and hospitalization rates across the US. To do so, the HF Stats SM initiative presented the latest data on epidemiology, differences, and outcomes of heart failure, according to sex, race and ethnicity, and age. Trends in these heart failure variables, while of critical importance, have not been compiled into a comprehensive document, despite concerning trends in incidence and mortality rates over the past decade.¹

Investigators aimed to provide a comprehensive synthesis of trends in heart failure epidemiology and outcomes as a cornerstone for clinical care, resource allocation, and research. The initiative set out to identify current knowledge gaps and limitations in epidemiologic data and to better forecast the future impact and burden of heart failure in the US.

“The inaugural HF StatsSM report has uncovered some truly remarkable and sobering data about the state of heart failure in the U.S. and around the world,” Bozkurt said.²

Key findings from the report suggest approximately 6.7 million people ≥20 years old in the US have heart failure, with an expected rise in prevalence to 8.5 million in the next decade. Lifetime risk has also increased, up to 24%, suggesting nearly 1 in 4 people will develop heart failure over their lifetime.¹

Nearly 1 in 3 (33%) adults in the US population are considered at-risk for heart failure (Stage A), while between 24–34% of the population has pre-heart failure (Stage B). For individuals with obesity and/or hypertension, the risks of heart failure have also increased.

Racial differences were also identified, as the incidence and prevalence of heart failure were higher among Black Individuals compared with other racial and ethnic groups. Over time, the prevalence of heart failure has grown among Black and Hispanic individuals. Among all individuals, heart failure mortality rates have been increasing since 2012.

The highest all-cause, age-adjusted mortality rates were identified in Black, American Indian, and Alaska Native individuals, compared with other groups. From 2010 - 2020, heart failure mortality rates grew for Black individuals at a rate higher than other racial or ethnic groups, particularly for those individuals ≤65 years.

Younger individuals (35-64 years) have also experienced a greater relative annual increase in heart failure-related mortality, compared with older (65 - 84 years) adults. The rates of heart failure hospitalization increased from 2014 to 2017, with a consistent increase between age and sex, but the higher rates among Black patients.

When considering location, the highest heart failure death rates have been reported in the Midwest, Southeast, and Southern states in the US. Compared with urban areas, rural areas have shown higher heart failure mortality rates for both younger and older populations.

The findings also touch on disparities in social determinants of health and health inequities in the US. Each is an important risk factor for heart failure and has been associated with increased mortality and other adverse risks in people at risk for heart failure or currently with heart failure.

According to the writing committee, the HFSA report will be released annually, and the focus will change each year, owing to the most significant findings observed during the research phase.

“Myself and others volunteering in HFSA leadership positions look forward to using HF StatsSM data to create new programs and interventions to address these issues in an effort to reverse these statistics,” Bozkurt said.²

References

1. Bozkurt B, Ahmad T, Alexander KM, et al. Heart failure epidemiology and outcomes statistics a report of the Heart Failure Society of America. Journal of Cardiac Failure. September 26, 2023. Accessed October 4, 2023. https://onlinejcf.com/article/S1071-9164(23)00264-6/fulltext.
2. Heart failure (HF) rate expected to rise to 8.5 million Americans by 2030. new HFSA initiative identifies rapidly changing landscape of HF in the U.S. HFSA. October 3, 2023. Accessed October 4, 2023. https://hfsa.org/heart-failure-hf-rate-expected-rise-85-million-americans-2030-new-hfsa-initiative-identifies.