Cited by 2,077Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsCardiac Fibrosis and Remodeling

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Epidemiology and risk profile of heart failure

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Bui, Anh L., Horwich, Tamara B., Fonarow, Gregg C.·2011·Nature Reviews Cardiology

DOI 10.1038/nrcardio.2010.165PMC PMC3033496

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Abstract

Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five. Although promising evidence shows that the age-adjusted incidence of HF may have plateaued, HF still carries substantial morbidity and mortality, with 5-year mortality that rival those of many cancers. HF represents a considerable burden to the health-care system, responsible for costs of more than $39 billion annually in the USA alone, and high rates of hospitalizations, readmissions, and outpatient visits. HF is not a single entity, but a clinical syndrome that may have different characteristics depending on age, sex, race or ethnicity, left ventricular ejection fraction (LVEF) status, and HF etiology. Furthermore, pathophysiological differences are observed among patients diagnosed with HF and reduced LVEF compared with HF and preserved LVEF, which are beginning to be better appreciated in epidemiological studies. A number of risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others, have been identified that both predict the incidence of HF as well as its severity. In this Review, we discuss key features of the epidemiology and risk profile of HF.

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Sinha, A., Gopinathan, P., Chung, Y.-D., Shiesh, S., & Lee, G. (2019) · Lab on a Chip · doi:10.1039/c9lc00115h · Cited by 47
Upstream regulation of the Hippo-Yap pathway in cardiomyocyte regeneration
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The Burden of Non-Cardiac Comorbidities and Association with Clinical Outcomes in an Acute Heart Failure Trial – Insights from ASCEND-HF
Bhatt, A. S., Ambrosy, A. P., Dunning, A. L., DeVore, A. D., Butler, J., Reed, S. D., Voors, A. A., Starling, R. C., Armstrong, P. W., Ezekowitz, J. A., et al. (2020) · European Journal of Heart Failure · doi:10.1002/ejhf.1795 · Cited by 47
Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure.
Mao, G. X., Cao, Y. B., Yang, Y., Chen, Z. M., Dong, J. H., Chen, S. S., Wu, Q. H., Lyu, X. L., Jia, B. B., Yan, J., et al. (2018) · PubMed · doi:10.3967/bes2018.020 · Cited by 47
The Relationship Between Medication Adherence and Coping Skills in Patients With Heart Failure
Seyedfatemi, N., Zeinali, E., Bahremand, M., Mehran, A., & Zeinali, M. (2019) · Avicenna Journal of Nursing and Midwifery Care · doi:10.30699/sjhnmf.27.2.89 · Cited by 46
“تسا1عیاش1رایسب 1لاح1رد1اکیرما1دحتم1تلاایا1رد1رفن1نویلیم15/81و1ناهج1رد 1رد1دیدج1صیخشت15500001ًابیرقت 1هنلااس1و1تسا1شیازفا 1تسا1فیعض1یرامیب1نیا1یهگآ1 شیپ1.[1]1دراد1دحتم1تلاایا 1ایند 1رد 1رفن 12830001دودح1گرم1هب 1هنالااس1هک1یروط1هب 1دصرد 261نآ1زا1یشان1یاه1ندش1یرتسب دادعت1و1دوش1 یم1رجنم 1تلع1نیلوا1یبلق1ییاسران1.”
Fusogenic Coiled-Coil Peptides Enhance Lipid Nanoparticle-Mediated mRNA Delivery upon Intramyocardial Administration
Zeng, Y., Sentí, M. E., Labonia, M. C. I., Papadopoulou, P., Brans, M. A. D., Dokter, I., Fens, M. H. A. M., van Mil, A., Sluijter, J. P. G., Schiffelers, R. M., et al. (2023) · ACS Nano · doi:10.1021/acsnano.3c05341 · Cited by 48
Artificial Intelligence Based Automated Medical Imaging Analysis and Interpretation
Jawar, S., & Kashyap, R. (2025) · OPJU International Technology Conference on Smart Computing for Innovation and Advancement in Industry (OTCON) · doi:10.1109/otcon65728.2025.11070779 · Cited by 46
“Instead of using human input and expertise, AI-based systems employ massive volumes of labeled medical imaging data to train models that can locate cancers, fractures, and disease progression [6].”
Calcium/Calmodulin-Dependent Protein Kinase II Couples Wnt Signaling With Histone Deacetylase 4 and Mediates Dishevelled-Induced Cardiomyopathy
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Epidemiology of heart failure and trends in diagnostic work-up: a retrospective, population-based cohort study in Sweden
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“The prevalence of HF depends on the definition used as well as on the age distribution of the population being assessed, but in Western countries it is estimated to affect ~1%–2% of the adult population, while the incidence rate is generally estimated to be 2–5/1,000 person-years.(4,7) A Swedish study conducted in pat…”
Background
Blood Pressure Variability and Risk of Heart Failure in ACCORD and the VADT
Nuyujukian, D. S., Koška, J., Bahn, G., Reaven, P. D., Zhou, J. J., & VADT Investigators (2020) · Diabetes Care · doi:10.2337/dc19-2540 · Cited by 46
“There is substantial evidence that HF represents an increasing burden in those with type 2 diabetes (19).”
Background
Bleeding in critical care associated with left ventricular assist devices: pathophysiology, symptoms, and management
Leebeek, F. W. G., & Muslem, R. (2019) · Hematology · doi:10.1182/hematology.2019000067 · Cited by 45
“35 million people suffer from this disease worldwide.(1,2) Despite the fact that heart transplantation remains the standard therapy for patients who progress to end-stage HF, only a limited number of patients eventually receive a donor heart.”
Background
Mixed Machine Learning Approach for Efficient Prediction of Human Heart Disease by Identifying the Numerical and Categorical Features
Ahmad, G. N., Shafiullah, Fatima, H., Abbas, M. A. E., Rahman, O., Imdadullah, A., & Alqahtani, M. S. (2022) · Applied Sciences · doi:10.3390/app12157449 · Cited by 67
Mettl3-mediated m6A modification of Fgf16 restricts cardiomyocyte proliferation during heart regeneration
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Telehealth care and remote monitoring strategies in heart failure patients: A systematic review and meta-analysis
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Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study
Ogah, O. S., Davison, B. A., Sliwa, K. S., Mayosi, B. M., Damasceno, A. A. M., Sani, M. U., Mondo, C. K., Dzudié, A., Ojji, D. B., Kouam, C. K., et al. (2015) · Clinical Research in Cardiology · doi:10.1007/s00392-015-0810-y · Cited by 45
“8 million persons are affected [2, 3] while over 23-million individuals have been estimated to have HF worldwide [2].”
Background
Improving Quality of Care and Outcomes for Heart Failure - Role of Registries -
Fonarow, G. C. (2011) · Circulation Journal · doi:10.1253/circj.cj-11-0582 · Cited by 45
Self-citation
Tanshinone IIA inhibits myocardial remodeling induced by pressure overload via suppressing oxidative stress and inflammation: Possible role of silent information regulator 1
Feng, J., Li, S., & Chen, H. (2016) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2016.09.041 · Cited by 45
Aucubin protects against pressure overload‐induced cardiac remodelling via the β 3 ‐adrenoceptor–neuronal NOS cascades
Wu, Q., Xiao, Y., Duan, M., Yuan, Y., Jiang, X., Yang, Z., Liao, H., Deng, W., & Tang, Q. (2018) · British Journal of Pharmacology · doi:10.1111/bph.14164 · Cited by 45
“Initially, these alterations are adaptive responses to maintain cardiac function; however, under conditions of sustained stress and as time progresses, these changes become maladaptive, and the heart ultimately fails (Bui et al., 2011).”
Background
Personalized immunosuppression in elderly renal transplant recipients
Peeters, L. E. J., Andrews, L. M., Hesselink, D. A., de Winter, B. C. M., & van Gelder, T. (2018) · Pharmacological Research · doi:10.1016/j.phrs.2018.02.031 · Cited by 45
“Whatever happens, happens” challenges of end-of-life communication from the perspective of older adults and family caregivers: a Qualitative study
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Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study
Lee, Y., Kim, D. H., Kim, S. M., Kim, N. H., Choi, K. M., Baik, S. H., Park, Y. G., Han, K., & Yoo, H. J. (2020) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01051-2 · Cited by 44
“People with HF experience a high burden of debilitating symptoms, which limit their daily activities [3, 4].”
Background
The impact of health education on treatment outcomes in heart failure patients
Świątoniowska-Lonc, N., Sławuta, A., Dudek, K. D., Jankowska, K., & Jankowska‐Polańska, B. (2020) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/115079 · Cited by 44
Remote Patient Monitoring in Heart Failure: Factors for Clinical Efficacy
Bhatia, A., & Maddox, T. M. (2020) · International Journal of Heart Failure · doi:10.36628/ijhf.2020.0023 · Cited by 45
Financial Toxicity of Medical Management of Heart Failure
Sukumar, S., Wasfy, J. H., Januzzi, J. L., Peppercorn, J. M., Chino, F. L., & Warraich, H. J. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.03.402 · Cited by 45
Machine learning for predicting in-hospital mortality in elderly patients with heart failure combined with hypertension: a multicenter retrospective study
Liu, X., Xie, Z., Zhang, Y., Huang, J., Kuang, L., Li, X., Li, H., Zou, Y., Xiang, T., Yin, N., et al. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02503-9 · Cited by 52
Regulator of G protein signalling 14 attenuates cardiac remodelling through the MEK–ERK1/2 signalling pathway
Li, Y., Tang, X., Li, X., Dai, H., Miao, R., Cai, J., Huang, Z., Chen, A. F., Xing, X., Lu, Y., et al. (2016) · Basic Research in Cardiology · doi:10.1007/s00395-016-0566-1 · Cited by 44
“Cardiac remodelling, including hypertrophy and fibrosis, is the major independent risk factor for heart failure, which usually develops in response to hypertension, myocardial infarction, valvular heart disease, and endocrine disorders [6, 26, 44].”
Background
Control of the Fluid Viscosity in a Mock Circulation
Boës, S., Ochsner, G., Amacher, R., Petrou, A., Meboldt, M., & Daners, M. S. (2017) · Artificial Organs · doi:10.1111/aor.12948 · Cited by 44
Comparison of Characteristics and 3-Year Outcomes in Patients With Acute Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction
Cho, J. H., Choe, W.-S., Cho, H., Lee, H., Jang, J., Lee, S. E., Choi, J., Jeon, E., Kim, M., Hwang, K., et al. (2018) · Circulation Journal · doi:10.1253/circj.cj-18-0543 · Cited by 43
Would You Prescribe Mobile Health Apps for Heart Failure Self-care? An Integrated Review of Commercially Available Mobile Technology for Heart Failure Patients
Mortara, A., Vaira, L., Palmieri, V., Iacoviello, M., Battistoni, I., Iacovoni, A., Macera, F., Pasqualucci, D., Bochicchio, M. A., & Maria, R. D. (2020) · Cardiac failure review · doi:10.15420/cfr.2019.11 · Cited by 44
“HF is a disease of the elderly: >80% of prevalent cases in the US and Europe are aged >65 years, with a median age at onset of 76 years.(16) Physical barriers, encompassing sensory, motor and cognitive changes related to normal ageing, and poor acceptance of the use of smartphones by the older population have been rep…”
Background
Alternative Splicing of NOX4 in the Failing Human Heart
Varga, Z. V., Pipicz, M., Baán, J. A., Baranyai, T., Koncsos, G., Leszek, P., Kuśmierczyk, M., Sánchez-Cabo, F., García-Pavía, P., Brenner, G. J., et al. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00935 · Cited by 43
“In spite of an overall decrease in coronary artery disease-related mortality, the number of patients suffering from heart failure is increasing steeply in aging societies (Rich, 2001; Bui et al., 2011).”
Background
Artificial Muscles and Soft Robotic Devices for Treatment of End‐Stage Heart Failure
Weymann, A., Foroughi, J., Vardanyan, R., Punjabi, P. P., Schmack, B., Aloko, S., Spinks, G. M., Wang, C., Rad, A. A., & Ruhparwar, A. (2022) · Advanced Materials · doi:10.1002/adma.202207390 · Cited by 44
Obesity: The Perfect Storm for Heart Failure
Lembo, M., Strisciuglio, T., Fonderico, C., Mancusi, C., Izzo, R., Trimarco, V., Bellis, A., Barbato, E., Esposito, G., Morisco, C., et al. (2024) · ESC Heart Failure · doi:10.1002/ehf2.14641 · Cited by 51
Topological and electrical control of cardiac differentiation and assembly
Thavandiran, N., Nunes, S. S., Xiao, Y., & Radisic, M. (2013) · Stem Cell Research & Therapy · doi:10.1186/scrt162 · Cited by 42
Long Non-Coding RNA Malat-1 Is Dispensable during Pressure Overload-Induced Cardiac Remodeling and Failure in Mice
Peters, T., Hermans-Beijnsberger, S., Beqqali, A., Bitsch, N. J. J. E., Nakagawa, S., Prasanth, K. V., Windt, L. J. D., van Oort, R. J., Heymans, S. R. B., & Schroen, B. L. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0150236 · Cited by 43
“About 23 million people worldwide suffer from HF, with the highest prevalence in the growing elderly population [18].”
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A longitudinal view of factors that influence the emotional well-being of family caregivers to individuals with heart failure
Grigorovich, A., Lee, A., Ross, H. J., Woodend, A. K., Forde, S., & Cameron, J. I. (2016) · Aging & Mental Health · doi:10.1080/13607863.2016.1168361 · Cited by 43
Early Postdischarge STOP-HF-Clinic Reduces 30-day Readmissions in Old and Frail Patients With Heart Failure.
Pacho, C., Domingo, M., Núñez, R., Lupón, J., Moliner, P., de Antonio, M., González, B., Santesmases, J., Vela, E., Tor, J., et al. (2017) · Revista Española de Cardiología · doi:10.1016/j.rec.2017.01.003 · Cited by 26
“This prospective single-center study was designed to include the most vulnerable patients admitted for acutely decompensated HF.”
BackgroundInfluential
High-sensitivity cardiac troponin I and risk of heart failure in patients with suspected acute coronary syndrome: a cohort study
Stelzle, D., Shah, A. S. V., Anand, A., Strachan, F. E., Chapman, A. R., Denvir, M. A., Mills, N. L., & McAllister, D. (2017) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcx022 · Cited by 44
Angiotensin‐converting enzyme 2–Angiotensin 1‐7/1‐9 system: novel promising targets for heart failure treatment
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Palliative care in heart failure
Wiskar, K., Toma, M., & Rush, B. N. M. (2018) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2018.02.008 · Cited by 42
Mineralocorticoid receptor antagonism improves diastolic dysfunction in chronic kidney disease in mice
Bonnard, B., Pieronne-Deperrois, M., Djerada, Z., Moghrabi, S. E., Kolkhof, P., Ouvrard‐Pascaud, A., Mulder, P. G. H., Jaisser, F., & Messaoudi, S. (2018) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2018.06.008 · Cited by 43
Impact of bariatric surgery on cardiovascular and renal complications of diabetes: a focus on clinical outcomes and putative mechanisms
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Current animal models for the study of congestion in heart failure: an overview
Cops, J., Haesen, S., Moor, B. D., Müllens, W., & Hansen, D. (2019) · Heart Failure Reviews · doi:10.1007/s10741-018-9762-4 · Cited by 43
Circulating irisin levels in heart failure with preserved or reduced ejection fraction: A pilot study
Silvestrini, A., Bruno, C., Vergani, E., Venuti, A., Favuzzi, A. M. R., Guidi, F., Nicolotti, N., Meucci, E., Mordente, A., & Mancini, A. (2019) · PLoS ONE · doi:10.1371/journal.pone.0210320 · Cited by 43
Nutrition in chronic heart failure patients: a systematic review
Bianchi, V. E. (2019) · Heart Failure Reviews · doi:10.1007/s10741-019-09891-1 · Cited by 44

Authors: Bui, A. L., Horwich, T. B., & Fonarow, G. C.
Affiliations: University of California, Los Angeles (US)
Corresponding author: Fonarow, Gregg C.
ORCID: Horwich, Tamara B.
Fonarow, Gregg C.
Venue: Nature Reviews Cardiology
Publisher: Springer Science and Business Media LLC
Published: 2010-11-09
Volume: 8
Issue: 1
Pages: 30-41
ISSN: 1759-5002 (ISSN-L)
1759-5010
DOI: 10.1038/nrcardio.2010.165
PMC: PMC3033496
OpenAlex: W1992644002
Cited by: 2,077
References: 144
Citations by year: 2026: 48 · 2025: 91 · 2024: 126 · 2023: 158 · 2022: 173 · 2021: 186 · 2020: 209 · 2019: 169 · 2018: 191 · 2017: 211 · 2016: 174 · 2015: 121 · 2014: 91 · 2013: 60 · 2012: 46
FWCI: 6.84
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Reviews Cardiology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Heart Failure Society of America
Ahmanson Foundation
National Institutes of Health (5k23hl085097-04)
National Heart, Lung, and Blood Institute (1K23HL085097, K23 HL085097, T32HL007895)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords: heart failure, heart failure epidemiology, heart failure risk factors, heart failure prevalence, heart failure mortality, health care costs, ischemic heart disease, hypertension, smoking, obesity, diabetes mellitus
MeSH terms: Adult, Aged, Female, Heart Failure, Humans, Male, Middle Aged, Prognosis, Risk Factors, Time Factors, Incidence, Prevalence, Risk Assessment

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Epidemiology and risk profile of heart failure

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