Conference Coverage

US Heart Failure Mortality Rises as Younger Adults Face Growing Burden

Ashton L. Stahl

Key Highlights

  • Heart failure contributed to 452,573 US deaths in 2023, accounting for 14.6% of all deaths.
  • Crude heart failure mortality rates increased 121% among adults aged 25–44 years from 2001 to 2020.
  • Electronic medical record data suggest only 18% of more than 3 million patients with reduced ejection fraction received quadruple guideline-directed medical therapy.

Heart failure mortality is rising in the United States, with younger adults experiencing substantial increases in disease burden, according to the Heart Failure Society of America’s (HFSA) HF Stats 2026: An Updated Report on Heart Failure Epidemiology and Outcomes Statistics. The report, published in the Journal of Cardiac Failure, identifies 12 principal findings describing changes in heart failure epidemiology, outcomes, treatment, and care infrastructure.

HFSA developed the annually updated resource to help clinicians, researchers, policymakers, and others understand the scope of heart failure in the United States.

Study Findings

Heart failure contributed to 452,573 US deaths in 2023, representing 14.6% of all-cause deaths. Age-adjusted heart failure mortality increased approximately 37% between 2010 and 2023, reversing more than a decade of previous progress. Preliminary 2024 data suggest the increase is continuing. Hospitalization rates rose among adults younger than 65 years between 2010 and 2022 but declined among those aged 65 years or older. From 2001 to 2020, crude mortality rates increased 121% among adults aged 25–44 years and 96% among those aged 45–64 years.

Approximately 7.7 million US adults, about 3% of the adult population, currently have heart failure. Prevalence is projected to reach 8.7 million by 2030 and 11.4 million by 2050. Nearly 1 in 4 Americans will develop heart failure during their lifetime. Black individuals have the highest age-adjusted incidence and mortality rates, while prevalence and outcomes vary across states and between rural and urban communities.

Clinical Implications

According to Eiran Gorodeski, MD, MPH, chair of the 2026 HFSA HF Stats Committee, the findings underscore the need for better prevention, earlier recognition, greater use of proven therapies, and continued research. Electronic medical record data suggest quadruple guideline-directed medical therapy is used in only 18% of more than 3 million patients with heart failure with reduced ejection fraction.

The report also identifies challenges in caring for patients with advanced disease. An estimated 350,000–500,000 US adults have stage D heart failure. As of June 2025, the United States had 1,523 physicians certified in advanced heart failure and transplant cardiology, alongside declining match applicants per position and gaps in multidisciplinary staffing.

Expert Commentary

“We have made extraordinary advances in our ability to treat heart failure, yet at the population level, the burden of heart failure continues to move in the wrong direction,” Gorodeski said in the press release.

Reference

Heart Failure Society of America. New HF Stats 2026 report finds heart failure mortality rising as disease increasingly affects younger Americans. Press release. October 5, 2026.