Lifetime Heart Failure Risk Increased to 24%, Driving Up Total Condition Cost

The lifetime risk of heart failure (HF) has increased to 24% and has driven up the condition’s cost in the US, according to a recent publication from the Heart Failure Society of America (HFSA).¹

Based on the HF Stats 2025: Heart Failure Epidemiology and Outcomes Statistics, roughly 6.7 million Americans over 20 years of age have HF. This prevalence is projected to increase to 8.7 million in 2030. HF is also a contributing cause in 425,147 deaths, making up 45% of all cardiovascular mortality in the US in 2022. The economic burden of HF is also rising significantly, with projections estimating total expenses at $858 billion by 2050.¹

“Heart failure is a growing epidemic affecting millions of individuals across all demographics,” Gregg Fonarow, MD, director of the Ahmanson-UCLA Cardiomyopathy Center and chair of the HFSA Data in HF Committee, said in a statement. “With a surge in mortality and continued underutilization of evidence-based therapies, it is imperative to prioritize improvements in the prevention, diagnosis, and treatment of heart failure.”¹

The lifetime risk of HF has risen to 24%, indicating that roughly 1 in 4 individuals will develop HF in their lifetime. Additionally, almost 1/3 of all US adults are at risk for HF, and 24-34% have pre-HF. 10-year HF risk has also increased, rising from 2% in 1990 to 3% in 2015.¹

The release also notes several disparities in treatment and management of HF. According to the document, roughly 25% of eligible patients with HF with reduced ejection fraction (HFrEF) are receiving quadruple guideline-directed medical therapy. Researchers have estimated optimal treatment implementation may save up to 1.19 million lives a year globally. Additionally, limited access to healthcare, socioeconomic factors, and differences in care generate substantial gaps in HF management and outcomes for vulnerable populations.²

Based on data from the Medical Expenditure Panel Survey, the HFSA release details the financial burden of HF treatment for both individuals and the healthcare industry at large. When all healthcare costs for patients with HF are accounted for, the annual per-patient cost was $32,995 in 2017-2018. When extrapolated across the overall HF population, this implies a $227 billion annual direct cost for patients with HF in 2020. Projections suggest it may rise to $858 billion by 2050. Hospitalizations accounted for almost 40% of these costs.²

The report also states that Black, American Indian, and Alaska Native individuals experience the highest HF incidence and prevalence rates among all racial and ethnic groups. From 2010 to 2020, mortality rose faster among Black patients than in any other group, with the greatest impact seen in adults <65 years of age.¹

Comorbidities were identified as a primary driver of these increases. Obesity, diabetes mellitus, hypertension, and chronic kidney disease are all major drivers of HF risk. When comparing data from 1999-2002 and 2015-2020, investigators found the proportion of individuals living with ≥3 cardiovascular-kidney-metabolic conditions has more than doubled.¹

References

1. Poko L. Cardiology Experts Warn of Growing Heart Failure Epidemic and Soaring Costs in New HF Stats 2025 Report. HFSA News. September 22, 2025. Accessed September 25, 2025. https://hfsa.org/cardiology-experts-warn-growing-heart-failure-epidemic-and-soaring-costs-new-hf-stats-2025-report

2. WRITING COMMITTEE MEMBERS. HF STATS 2025: Heart Failure Epidemiology and Outcomes Statistics an Updated 2025 Report from the Heart Failure Society of America. J Card Fail. Published online August 29, 2025. doi:10.1016/j.cardfail.2025.07.007