- Heart failure hospitalization and mortality rates are increasing among adults under 65, highlighting a growing concern for younger adults.
- The global burden of heart failure has grown significantly since 1990, with researchers pointing to population growth and aging as major contributing factors.
- While the underlying causes of heart failure vary by age and region, managing risk factors such as high blood pressure, diabetes, and obesity may help prevent the condition.
Heart failure is a chronic condition in which the heart cannot pump enough blood to meet the body’s needs. Despite its name, heart failure doesn’t mean the heart has stopped beating.
A separate 2026 report from the Heart Failure Society of America (HFSA) found that heart failure contributed to more than 450,000 deaths in the United States in 2023, with particularly sharp increases in mortality among adults under 65.
Approximately 7.7 million U.S. adults (3%) are living with heart failure, according to the HFSA report. That number is projected to rise to 8.7 million by 2030, 10.3 million by 2040, and 11.4 million by 2050.
The GBD researchers said the findings highlight the growing burden of heart failure associated with population growth and aging, as well as the need for prevention and treatment strategies targeting common causes such as ischemic heart disease and hypertension (high blood pressure).
Between 2010 and 2022, heart failure hospitalization rates increased among adults under 65 while declining among those 65 and older. Between 2001 and 2020, estimated heart failure mortality rates more than doubled among adults ages 25 to 44 and nearly doubled among those ages 45 to 64.
“I think we’re seeing the impact of cardiovascular risk factors developing earlier in life. Conditions such as obesity, diabetes, hypertension, and sleep apnea are affecting younger adults at higher rates than in previous generations,” Kevin Shah, MD, Program Director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in Long Beach, CA, who wasn’t involved in the analysis, told Healthline.
“When those risk factors are present for decades, they can eventually lead to heart failure at a younger age,” he said.
Amit Blumfield, MD, a cardiologist at Manhattan Cardiology in New York City who was also not involved in the analysis, noted that improvements in early detection may also play a role.
“Our tools to detect early heart failure are also improving with time, and as a result, patients may receive an earlier diagnosis and can hopefully start medical therapy to prevent progression or possibly even reverse the process entirely.”
Heart failure contributed to 452,573 deaths in the United States in 2023, accounting for approximately 14.6% of all deaths that year, according to the HFSA report.
Age-adjusted heart failure mortality rates increased by approximately 37% between 2010 and 2023, with preliminary 2024 data suggesting the upward trend is continuing.
This increase appears to have reversed more than a decade of previous progress in reducing heart failure mortality.
Ischemic heart disease and hypertension were among the most common causes of heart failure in older adults, according to the GBD report. However, the underlying causes varied considerably by age group and region.
Among children and young adults, congenital heart abnormalities and rheumatic heart disease (RHD) were common causes of heart failure. Heart failure associated with alcohol use was most prevalent during middle adulthood.
The analysis also identified regional differences in the underlying causes of heart failure:
- Rheumatic heart disease: South Asia, East Asia, Oceania, Southeast Asia, and parts of sub-Saharan Africa
- Alcohol use: Eastern Europe, Australasia, the Caribbean, and Central Europe
- Chagas disease: Southern, Andean, tropical, and central Latin America
The global burden of heart failure is expected to grow as populations age.
While not all cases of heart failure can be prevented, managing certain risk factors can help reduce your risk. These include:
- High blood pressure
- Excessive alcohol consumption
- Tobacco use
According to Shah, other important steps to help prevent heart failure include maintaining a healthy weight, staying physically active, and managing conditions such as diabetes and high cholesterol.
He added that regular medical care is important because many of these risk factors can be identified and treated long before heart failure develops.
“Heart failure is often treatable and may even be reversible with early diagnosis and treatment. It is important for patients to seek help early if they have concerning symptoms, such as exertional shortness of breath, chest pain, leg swelling, or anything else they’re concerned about. Talk with your doctors early and often,” said Blumfield.
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