Heart failure & cardiomyopathies

The Evolving Burden, Disparities, Drivers, and Prevention Priorities of Heart Failure in the United States

JACC AdvPublished Global Burden of Disease Study 2023

Authors' conclusion

HF remains a substantial and persistent public health burden in the United States. These findings support more targeted prevention, improved risk-factor control, and more equitable delivery of HF care.

Study context

Population
United States, 1990 to 2023
Outcome
Prevalent HF cases and YLDs
Follow-up
2023
Methodological detailscomplementary cause-pathway framework, data-driven machine-learning approach, Bayesian age-period-cohort models
  • Complementary cause-pathway framework
  • Data-driven machine-learning approach
  • Bayesian age-period-cohort models

Main finding

As reported in the abstract

2023

Prevalent heart failure (HF) cases

4.65 million

Years lived with disability (YLDs)

432 thousand

Increase in absolute burden since 1990

≈80%

Observational data: associations, not effects.

Further findings

Age-standardized prevalence and YLD rates · 2023

Age-standardized prevalence rate per 100,000
864.29 (95% UI 789.90-937.31)
Age-standardized YLD rate per 100,000
80.41 (95% UI 56.41-110.96)
Age-standardized rates remained largely stable

Etiologic profile of HF

Dominated by ischemic, hypertensive, valvular, and cardiomyopathic pathways

Geographic disparities

Disproportionate burden concentrated in several Midwestern and Southern states

Population-attributable fraction by risk factor

High systolic blood pressure
40.7%
Dietary risks
27.3%
High BMI
22.5%
High low-density lipoprotein cholesterol
11.5%
Kidney dysfunction
10.9%

Projected HF burden · through 2040

Broadly stable trends

Original publication

The Evolving Burden, Disparities, Drivers, and Prevention Priorities of Heart Failure in the United States. JACC Adv. Published 9 September 2026. doi:10.1016/j.jacadv.2026.103206

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