2023 Report Summary

Needs Assessment and Goals

Trends in the epidemiology and outcomes for heart failure (HF) are critically important and have not been explicated and compiled in a comprehensive contemporary document. There have been concerning trends in the incidence, prevalence, mortality, and HF hospitalization rates over the past decade. Therefore, the speciļ¬c goals of the report are:

  1. To establish a clear and comprehensive synthesis of trends in HF epidemiology and outcomes as a foundation for clinical care, resource allocation, and research.
  2. To address differences in HF epidemiology and outcomes according to sex, race, ethnicity, and age.
  3. To identify current knowledge gaps and limitations in HF epidemiologic data and to forecast the future impact and burden of HF.

The emphasis of the report is epidemiological trends in the United States (US), but when applicable, global trends are also included.

Summary of Top 10 Key Points

  1. Approximately 6.7 million Americans over 20 years of age have heart failure (HF), and the prevalence is expected to rise to 8.5 million Americans by 2030.
  2. The lifetime risk of HF has increased to 24%; approximately 1 in 4 persons will develop HF in their lifetime.
  3. Approximately 33% of the United States (US) adult population is at-risk for HF (Stage A HF) and 24-34% of the US population have pre-HF (Stage B HF). The risk of developing HF in individuals with obesity and hypertension has increased.
  4. The incidence and prevalence of HF is higher among Black individuals compared with other racial and ethnic groups. The prevalence of HF has increased among Black and Hispanic individuals over time.
  5. HF mortality rates have been increasing since 2012.
  6. Black, American Indian, and Alaska Native individuals have the highest all-cause age-adjusted HF mortality rates compared with other racial and ethnic groups. From 2010 to 2020, HF mortality rates have increased for Black women and men at a rate higher than any other racial or ethnic groups, particularly for individuals below the age of 65.
  7. A greater relative annual increase in HF-related mortality rates has been noted for younger (35-64 years) compared with older (65-84 years) adults.
  8. Highest HF death rates have been reported in the Midwest, Southeast, and Southern states. Rural areas demonstrate higher HF mortality rates for both younger and older age groups compared with urban areas.
  9. Rates of HF hospitalizations have increased from 2014 to 2017. This increase was consistent between age groups and sexes, with the highest rates being among Black patients.
  10. Disparities in social determinants of health and health inequities are important HF risk factors and result in increased mortality and other adverse outcomes in individuals at risk for HF or with HF.