An Update on the Prevalence of Heart Failure

Abstract

Heart failure (HF) constitutes a global public health problem. The clinical epidemiology of HF has not been clearly appreciated over the world. In addition, the prevalence of HF reported in the literature depends on the definition used. No data are available yet on HF prevalence in accordance with the new 2021 European Society of Cardiology (ESC) and 2022 American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA) guideline definitions. In developed countries, the prevalence of HF ranges between 1% and 3% of the general adult population. Estimates from low-income countries are scarce. HF is particularly prevalent among older individuals. According to registry data from Western countries, up to roughly 50% of patients have HF with a reduced ejection fraction (EF). This subtype of HF is most likely to remain stable or even decline, whereas the prevalence of HF with preserved EF is steadily increasing. The total number of HF patients is still continuing to rise due to a growing and aging population, improved availability of diagnostic tools, and progress in medical treatments that aid in prolonging life. These findings indicate that the worldwide epidemic of HF may progress even more rapidly than assumed so far. It is also important to establish the role of asymptomatic left ventricular dysfunction (ALVD) in the natural history of HF and the potential for its prevention.