WRITING COMMITTEE MEMBERS Gregg C. Fonarow, MD (Chair), Faraz S. Ahmad, MD, MS, Tariq Ahmad, MD, MPH, Nancy M. Albert, PhD, Kevin M. Alexander, MD, William L. Baker, PharmD, Biykem Bozkurt, MD, Khadijah Breathett, MD, MS, Spencer Carter, MD, Richard K. Cheng, MD, Anita Deswal, MD, MPH, Mark H. Drazner, MD, MSc, Shannon Dunlay, MD, Eiran Z. Gorodeski, MD, MPH, Stephen J. Greene, MD, Paul Heidenreich, MD, Eileen Hsich, MD, Lenette Jones, PhD, Manreet Kanwar, MD, Prateeti Khazanie, MD, MPH, Kiran Khush, MD, Todd Koelling, MD, Christopher S. Lee, PhD, Robert Page, II, PharmD, Ambarish Pandey, MD, Nosheen Reza, MD, MS, Alexander T. Sandhu, MD, MS, Palak Shah, MD, MS, Josef Stehlik, MD, MPH, Ryan J. Tedford, MD, John R. Teerlink, MD, Amanda R. Vest, MBBS, MPH, Clyde Yancy, MD, MSc, Boback Ziaeian, MD, PhD

J Card Fail. 2025 DOI: https://doi.org/10.1016/j.cardfail.2025.07.007
Published September 2025

Supporting Materials

Top 10 Takeaways

1. 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.
2. 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.
3. 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. 
4. 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. 
5. 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. 
6. 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.
7. 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.
8. 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. 
9. 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. 
10. 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.

Press Release

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, DC (SEPTEMBER 22, 2025) – 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).