According to a report from the Heart Failure Society of America (HFSA) published in the Journal of Cardiac Failure, around 6.7 million Americans aged 20 years old and over have heart failure (HF).
Shocking heart failure rates
Cardiology experts are warning about the concerning increase in heart failure prevalence, mortality, worsening disparities, impact on younger patients, and the debilitating condition in the United States of America. The report states that approximately 6.7 million Americans over the age of 20 years old are currently living with heart failure, this number is projected to increase to 8.7 million by 2030, to 10.3 million by 2040, and reach an alarming 11.4 million by 2050.
This year’s report reveals some of the most alarming trends seen in heart failures. While the rates have been steadily increasing over the last decade, the problem has become even more severe, especially among younger populations, racial and ethnic minority groups, and those with multiple health conditions.
Reporting and coding inconsistencies
The report also noted that there are problems with reporting as well as inconsistent coding practices that fail to recognize heart failure as a primary underlying cause of death which may lead to under-detection and under-reporting. This means that the actual burden of heart failure is likely to be higher than the current data shows.
“The shifts in age distribution, worsening in mortality rates, widening racial and ethnic disparities –which may be a reflection of systematic and structural barriers to appropriate and timely health care – should be a wake-up call for clinicians, payers, legislators, funding agencies, and the overall healthcare system,” said Biykem Bozkurt, MD, PhD, Baylor College of Medicine and chair of the HFSA Data in HF Committee.
“We need to address worsening trends in heart failure, not only through medical interventions and properly implemented GDMT, but by tackling the growing challenges in health care regarding access and coverage for appropriate and timely care, the effect of mis-incentivization of wrong care such as inappropriate discontinuation of therapies, and social determinants of health that are driving widening disparities.”
HFSA Highlights that reveal an evolving crisis:
- Greater Impact on Younger Patients: The proportion of younger patients (aged 35-64) with heart failure has increased, showing a higher annual rise in mortality compared to older adults. This trend suggests that heart failure is no longer just a disease of aging but one that is increasingly affecting younger populations.
- Mortality Surge in 2021: While the 2023 report noted an upward trend in HF-related deaths since 2012, the 2024 report reveals a significant acceleration in 2020-2021, when 425,147 deaths were linked to HF, accounting for 45% of cardiovascular deaths.
- Racial Disparities Worsening: As in previous years, Black, American Indian, and Alaska Native individuals continue to have the highest all-cause age-adjusted HF mortality rates. The mortality rate for Black individuals has risen faster than any other racial or ethnic group, particularly in those under 65. The overall prevalence of heart failure has also increased among Black and Hispanic populations.
- Impact of Comorbidities: Obesity and hypertension remain critical risk factors for heart failure, but the 2024 report emphasizes the rising threat of clusters of comorbidities—multiple health conditions that are compounding the risk of HF.
- COVID-19 Impact: For the first time, this year’s report noted that HF hospitalization rates were temporarily reduced between 2020-2022 due to the pandemic. However, long-term trends still show a steady increase in hospitalizations across all age groups and racial categories, with Black patients disproportionately affected
