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Epidemiology and risk profile of heart failure
Open accessAbstract
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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“Despite advancements in clinical management, MI and ischemic cardiomyopathy are among the leading causes of heart failure, associated morbidity, and death worldwide 3,4 and continue to impose staggering financial burden on healthcare systems 3,5-8 .”
From Targeting the Immune-Fibrosis Axis in Myocardial Infarction and Heart Failure (2022) · cites this paper as [8]
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“therapies for chronic conditions may be limited when treatments that are beneficial in one condition are detrimental in another; for example, β-blockers in the presence of lung disease, ACE inhibitors in the presence of kidney disease, or nonsteroidal anti-inflammatory drugs for arthritis are contraindicated in HF”
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“Future directions As the prevalence of HF continues to increase, it will be necessary to more effectively prevent the occurrence of HF to address the global burden of this syndrome”
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“The worldwide prevalence of HF seems to have been increasing over the past decades”
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“The worldwide prevalence of HF seems to have been increasing over the past decades”
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Economic burden of heart failure: A summary of recent literature
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“Hospitalizations are the main driver of total HF costs”
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“8% every year in patients with HF from 1979 to 1999”
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Spectrum of heart failure in older patients: Results from the national heart failure project
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“In a study of elderly US Medicare beneficiaries hospitalized for HF, comorbidities were common, including hypertension (61%), coronary artery disease (56%), diabetes (38%), chronic obstructive pulmonary disease (33%), and atrial fibrillation (30%)”
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Self-citationThe epidemiological features of heart failure in developing countries: a review of the literature
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“Incidence and prevalence data for HF in most countries are scarce”
BackgroundBarker, W. H., Mullooly, J. P., & Getchell, W. S. (2006) · Circulation · doi:10.1161/circulationaha.104.492033 · Cited by 262
Contractile Behavior of the Left Ventricle in Diastolic Heart Failure
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“The left ventricle in patients with HF and preserved LVEF may be characterized by concentric remodeling, LV hypertrophy, increased extracellular matrix, abnormal relaxation and filling, decreased diastolic distensibility, and abnormal calcium handling”
Risk factors for heart failure in the elderly: a prospective community-based study
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Heart Failure — An Epidemic of Uncertain Proportions
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“Such trends may have resulted from demographic shifts, changes in the prevalence of risk factors, or improvements in the availability and application of HF treatments”
BackgroundTotal Serum Cholesterol Levels and Mortality Risk as a Function of Age
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“an increased ratio of total cholesterol to HDL cholesterol is associated with elevated HF risk”
BackgroundHeart Failure Survival Among Older Adults in the United States
Croft, J. B., Giles, W. H., Pollard, R. A., Keenan, N. L., Casper, M. L., & Anda, R. F. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.5.505 · Cited by 240
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“Not all studies consistently find a continuing rise in hospitalizations; Stewart and colleagues concluded that the hospitalization rate in Scotland steadied in the 1990s”
BackgroundCongestive Heart Failure in the United States
Goff, D. C., Pandey, D. K., Chan, F. A., Ortiz, C., & Nichaman, M. Z. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.2.197 · Cited by 223
Risk Factors for Heart Failure
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“Cost At present, developed countries devote 1–2% of all health-care expenditures towards HF”
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ABC of heart failure: History and epidemiology
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Long-term Survival After Heart Failure
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“In the SOLVD trials (Studies Of Left Ventricular Dysfunction)”
Background2006 National Hospital Discharge Survey.
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Predictors of heart failure among women with coronary disease
Bibbins-Domingo, K., Lin, F., Vittinghoff, E., Barrett-Connor, E., Hulley, S. B., Grady, D., & Shlipak, M. G. (2004) · Circulation · doi:10.1161/01.cir.0000141726.01302.83 · Cited by 171 · cited 1×
“Further evaluation of the elevated risk particularly in women, was addressed by HERS (Heart and Estrogen/progestin Replacement Study) and its follow-up (HERS II)”
BackgroundIncidence of Heart Failure after Myocardial Infarction: Is It Changing over Time?
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Extending the Horizon in Chronic Heart Failure
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“Such efforts may require changes in discharge planning or disease management at home”
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Costs for Heart Failure With Normal vs Reduced Ejection Fraction
Liao, L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.1.112 · Cited by 130 · cited 1×
“Over a 5-year period, patients with HF and preserved LVEF will consume as many health-care resources as those with HF and reduced LVEF”
BackgroundIncidence and hospital death rates associated with heart failure: A community-wide perspective
Goldberg, R. J., Spencer, F. A., Farmer, C., Meyer, T. E., & Pezzella, S. M. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.04.013 · Cited by 129 · cited 1×
“Among those with established HF, however, there is evidence that obesity is associated with improved outcomes”
BackgroundTemporal Trends in Event Rates After Q-Wave Myocardial Infarction
Guidry, U. C., Evans, J. C., Larson, M. G., Wilson, P. W. F., Murabito, J. M., & Levy, D. A. (1999) · Circulation · doi:10.1161/01.cir.100.20.2054 · Cited by 124 · cited 1×
“An earlier study of the Framingham Heart Study also found no change in the incidence of post-MI HF between 1950 and 1989”
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“Risk factors associated with HF and preserved LVEF The relative contributions of risk factors and risk profile also differ for patients with HF and preserved LVEF compared with patients with HF and reduced LVEF”
BackgroundHeart Failure in African Americans
Yancy, C. W. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.07.028 · Cited by 108 · cited 1×
“In the USA, black individuals tend to have a higher prevalence of HF and present with HF at a younger age than those who are white”
BackgroundThe diagnosis of heart failure in the community
Bari, M. D., Pozzi, C., Cavallini, M. C., Innocenti, F., Baldereschi, G. J., Alfieri, W. D., Antonini, E., Pini, R., Masotti, G., & Marchionni, N. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.07.022 · Cited by 105
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“In the HERS study, poor renal function (creatinine clearance”
BackgroundTen-Year Trends in Hospital Care for Congestive Heart Failure
Polanczyk, C. A., Rohde, L. E. P., DEC, G. W., & DiSalvo, T. G. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.3.325 · Cited by 91
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An epidemic of heart failure? Recent evidence from Europe.
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“In a study of 1,516 outpatients in EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study)”
BackgroundSurvival Associated with Two Sets of Diagnostic Criteria for Congestive Heart Failure
Schellenbaum, G. D. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh268 · Cited by 82
Polypharmacy and comorbidity in heart failure
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“As elderly individuals are disproportionately affected by HF, multiple other comorbid conditions are frequently present in patients with HF”
BackgroundCystatin C and risk of heart failure in the Physicians' Health Study (PHS)
Djoussé, L., Kurth, T., & Gaziano, J. M. (2007) · American Heart Journal · doi:10.1016/j.ahj.2007.08.023 · Cited by 60
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Modifiable Risk Factors for Incident Heart Failure in the Coronary Artery Surgery Study
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Analysis of trends in hospitalizations for heart failure
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“In-hospital mortality from HF has generally improved over time”
BackgroundThe Framingham Heart Study: review of epidemiological design and data, limitations and prospects.
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“Such efforts may require changes in discharge planning or disease management at home”
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Secular trends of heart failure among US male physicians
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“Treatment of hypertension, however, can reduce the incidence of HF by almost 50%”
Background
Research works printed but not linked: 1
- Gordis, L. Epidemiology 37–84 (Elsevier/Saunders, Philadelphia, 2009).
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Self-citationHeart Failure: Preventing Disease and Death Worldwide
Ponikowski, P. P., Anker, S. D., AlHabib, K. F., Cowie, M., Force, T. L., Hu, S., Jaarsma, T., Krum, H., Rastogi, V., Rohde, L. E. P., et al. (2014) · ESC Heart Failure · doi:10.1002/ehf2.12005 · Cited by 1,777
“Being severely overweight has been shown to double the risk of heart failure and smoking to increase it by about 50%.(38)”
BackgroundMultimorbidity in Older Adults
Salive, M. E. (2013) · Epidemiologic Reviews · doi:10.1093/epirev/mxs009 · Cited by 1,366
“They tend to be higher than the rates reported in studies that used clinical methods; for example, the prevalence of heart failure in this study was 18% in the older adults, versus 5%–15% in national data from the United States (23).”
ResultInfluentialConrad, N., Judge, A., Tran, J., Mohseni, H., Hedgecott, D., Perez-Crespillo, A., Allison, M., Hemingway, H., Cleland, J. G. F., McMurray, J. J. V., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32520-5 · Cited by 1,390
Metadata
- Authors
- Bui, A. L., Horwich, T. B., & Fonarow, G. C.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Fonarow, Gregg C.
- Venue
- Nature Reviews Cardiology
- Published
- 2010-11-09
- Volume
- 8
- Issue
- 1
- Pages
- 30-41
- ISSN
- 1759-5002 (ISSN-L)
- 1759-5010
- 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
- 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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