Heart failure & cardiomyopathiesCross-sectional study
Trends in the Prevalence, Associated Risk Factors, and Health Burden of Heart Failure in the United States, 1988 to 2023
- Serial cross-sectional study
- nationally representative sample
Authors' conclusion
From 1988 to 2023, the number of U.S. adults with HF increased from 3.3 to 7.4 million. Age-standardized prevalence was constant.
Study context
- Population
- US ambulatory adults aged ≥20 years3,078 with heart failure (HF)
- Participants
- 83,552 adults
- Exposure
- 2023 vs 1988
- Outcome
- Prevalence of self-reported HF
Main finding
Crude prevalence of HF
Increase
43%
95% CI 8%–91%
By group
2023 vs 1988
increase 43% (95% CI 8%–91%)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Risk factor prevalence among respondents with HF (1988 to 2023)
- Obesity 32.5% → 60.4%, PR
- 1.86 (95% CI: 1.36-2.55)
- Impaired glucose homeostasis 48.6% → 69.2%, PR
- 1.42 (95% CI: 1.14-1.77)
- Diabetes 21.2% → 36.2%, PR
- 1.71 (95% CI: 1.28-2.29)
- CKD 38.6% → 52.3%, PR
- 1.35 (95% CI: 1.08-1.70)
- Elevated BP 80.7% → 49.1%, PR
- 0.61 (95% CI: 0.51-0.73)
- Hypercholesterolemia 71.5% → 22.6%, PR
- 0.32 (95% CI: 0.21-0.47)
- Myocardial infarction (MI) history 59.3% → 42.1%, PR
- 0.71 (95% CI: 0.57-0.88)
- PR = prevalence ratio
Risk factor trends, HF vs no HF
- More pronounced with HF: reductions in elevated BP, hypercholesterolemia, MI and increases in obesity
Mortality
- Significant reductions in CV and all-cause mortality; all-cause partially offset by increases in non-CV mortality
Self-reported health, physical function, work-related impairments
- Self-reported health and physical function improved; work-related impairments persisted
Original publication
Trends in the Prevalence, Associated Risk Factors, and Health Burden of Heart Failure in the United States, 1988 to 2023. J Am Coll Cardiol. Published 26 November 2025. doi:10.1016/j.jacc.2025.09.1503
Summarised from the published abstract; every number is checked against it