Cardiology Experts Warn of Growing Heart Failure Epidemic and Soaring Costs in New HF Stats 2025 Report

The lifetime risk of Heart Failure has increased to 24%, while related costs are projected to grow significantly and could rise to $858 billion.

WASHINGTON, Sept. 22, 2025 /PRNewswire/ -- The latest findings on heart failure (HF) published by the Heart Failure Society of America (HFSA) reveal that the lifetime risk of HF has increased to 24%, while the cost of this debilitating condition in the United States continues to soar. According to the HF Stats 2025: Heart Failure Epidemiology and Outcomes Statistics, approximately 6.7 million Americans over 20 years of age have HF, and the prevalence is expected to rise to 8.7 million in 2030. Heart failure was a contributing cause in 425,147 deaths, accounting for 45% of cardiovascular deaths in the United States in 2022. While the cost of managing HF continues to rise, with projections estimating that total HF-related expenses could reach $858 billion by 2050. The report was published today in the Journal of Cardiac Failure (JCF). 

The costs of Heart Failure are projected to grow significantly and could rise to $858 billion by 2025.

Assessing the economic burden of HF is influenced by multiple factors such as quality of care, access to treatment, and the rising incidence and prevalence across multiple patient populations. The 2025 Report highlights key cost drivers and trends that continue to contribute to escalating HF-related expenses. New areas of focus include the increasing prevalence of HF—particularly advanced HF—the incidence, prevalence, and outcomes of hypertrophic cardiomyopathy, and the impact of hypertension, obesity, and cardiovascular-kidney-metabolic risk factors. These findings provide a clear view of the evolving HF landscape and its implications for patient care and healthcare costs.

The 2025 report also highlights concerning disparities in the management of HF. The findings reveal significant gaps, inconsistencies, and inequalities in the application of guideline-recommended therapies for heart failure. Remarkably, fewer than one in four eligible patients with heart failure and reduced ejection fraction are receiving quadruple guideline-directed medical therapy. It is projected that the optimal implementation of these therapies could potentially save approximately 1.19 million lives annually worldwide.

"Heart failure is a growing epidemic affecting millions of individuals across all demographics. 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," said Gregg C. Fonarow, MD, Director of the Ahmanson-UCLA Cardiomyopathy Center and chair of the HFSA Data in HF Committee.

 Concerning Findings from the HF Stats 2025: Heart Failure Epidemiology and Outcomes Statistics:

The HF Stats 2025: Heart Failure Epidemiology and Outcomes Statistics highlights several key findings, revealing this evolving epidemic could impact millions of Americans over the coming years: 

• Comorbidities as Key Risk Multipliers: Obesity, diabetes mellitus, hypertension, and chronic kidney disease remain major drivers of HF risk. Comparing national data from 1999–2002 and 2015–2020 reveals that the proportion of individuals living with three or more cardiovascular-kidney-metabolic conditions has more than doubled, underscoring the growing burden of multimorbidity.
• Critical Gaps in Diagnosis: Cardiomyopathies such as cardiac amyloidosis and hypertrophic cardiomyopathy remain widely underdiagnosed. These conditions are frequently misdiagnosed as more common forms of HF, such as HF with preserved ejection fraction or hypertensive heart disease, often resulting in delayed or missed opportunities for targeted treatment.
• Disproportionate HF Burden on Black Americans: Black individuals experience the highest rates of HF incidence and prevalence among all racial and ethnic groups. Alarmingly, HF-related mortality in this population is rising faster than in any other group, with the greatest impact seen in adults under age 65.

Additional information may be found at HFStats.org, an online resource designed to help interpret and share the data, including infographics, fact sheets, and downloadable statistics. Updated and new statistics from HF Stats 2025: Heart Failure Epidemiology and Outcomes Statistics will be made available on HFStats.org in the coming months. At the present time, the report is published in JCF and available online under Articles in Press at www.onlinejcf.com.

https://doi.org/10.1016/j.cardfail.2025.07.007

Summary of Top 10 Key Points

Heart failure (HF) was a contributing cause in 425,147 deaths, accounting for 45% of cardiovascular deaths in the U.S. in 2022. HF mortality rates have been increasing since 2012, with a more pronounced acceleration in 2020-2021. The age-adjusted HF mortality rates were higher in 2021 than in 1999, highlighting an urgent need for improved HF prevention, implementation of guideline-directed therapies, and further research.

Black, American Indian, and Alaska Native individuals have the highest all-cause age-adjusted HF mortality rates compared with other racial and ethnic groups. From 2010 to 2020, HF mortality rates increased for Black individuals at a rate higher than any other racial or ethnic group, particularly for individuals below the age of 65.

Approximately 6.7 million Americans over 20 years of age have HF, and the prevalence is expected to rise to 8.7 million in 2030, 10.3 million in 2040, and 11.4 million by 2050.

The lifetime risk of HF has increased to 24%; approximately 1 in 4 individuals will develop HF in their lifetime. The age-adjusted incidence and prevalence of HF are higher among Black individuals compared with other racial and ethnic groups.

Approximately one-third of the adult population in the U.S. is at risk for HF (Stage A), and 24-34% of the U.S. population has pre-HF (Stage B). The risk of developing HF is increased in individuals with obesity, diabetes mellitus (DM), hypertension, and chronic kidney disease. When comparing 1999-2002 to 2015-2020 data, the proportion of individuals having 3 cardiovascular-kidney-metabolic conditions has more than doubled.

Cardiac amyloidosis and hypertrophic cardiomyopathy are specific cardiomyopathies that are underdiagnosed and often mistaken for other, more common cardiac conditions like HF with preserved ejection fraction or hypertensive heart disease. With improved awareness, imaging, and genetic testing, clinicians are diagnosing these cardiomyopathies earlier, more accurately, and more frequently. Further, there are now specifically targeted therapies that go beyond just symptom control for these cardiomyopathies and address the underlying pathophysiology.

Stage C2D describes ambulatory patients with features of advanced HF, including daily symptoms and reduced functional capacity, despite guideline-directed medical therapies. The prevalence of stage C2D and stage D HF requires further examination. It has been estimated that 5-7% of patients with symptomatic HF have advanced HF.

There were 1.2 million primary HF hospitalizations among 949,075 unique patients in 2021. Rates of HF hospitalizations have increased since 2014. This increase was consistent between age groups and sexes, with the highest rates being among Black individuals.

There are significant gaps, variations, and disparities in the use of guideline-recommended therapies for HF. Notably, less than one in four eligible patients with HF with reduced ejection fraction are receiving quadruple guideline-directed medical therapy. Optimal implementation could save an estimated 1.19 million lives a year globally.

Heart failure accounted for an estimated $32 billion in direct medical costs and $14 billion in indirect costs in the U.S. in 2020, with projections that HF costs could reach $142 billion by 2050. However, other analyses suggest total direct costs for HF may be as high as $227 billion in 2020, with projections up to $858 billion by 2050.

About the Journal of Cardiac Failure

The Journal of Cardiac Failure (JCF) publishes the highest quality science in the field of heart failure with a focus on diversity, equity, and inclusion, mentorship, multidisciplinary partnerships, and patient-centeredness. Published papers span original investigator-initiated work to state-of-the-art reviews, guidelines and scientific statements, expert perspectives, early career and trainee spotlight pieces, patient and patient-partner narratives. JCF also emphasizes the power of language and prioritizes innovative approaches to the dissemination of published work to reach and impact the broader heart failure community.

About the Heart Failure Society of America

The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers, and patients. For more information, visit hfsa.org.

Media Contact: Laura Poko, 301-798-4493, ext. 226, lpoko@hfsa.org 

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SOURCE Heart Failure Society of America