Epidemiology

Estimates based on National Health and Nutrition Examination Survey (NHANES) data from 2017-2020 suggest that around 6.7 million adults ≥20 years of age had heart failure (HF) in the US.[9]​​ ​Prevalence is increasing in the US, and is projected to rise from 2.4% of the total US population in 2012 to 3.0% in 2030.​[9]​ The CaReMe study, which uses data from healthcare registries in Belgium, Canada, Germany, Israel, Italy, Norway, Portugal, Spain, Sweden, Switzerland, and the UK, reported the prevalence of HF in the adult population to be 1% to 2%, depending on whether a broad or strict definition was used.[10]

​The incidence and prevalence of HFpEF specifically are increasing, and are increasing relative to heart failure with reduced ejection fraction (HFrEF).[11]​ Studies suggest that approximately 50% of heart failure patients have HFpEF; however, HFpEF is expected to become the most prevalent HF subtype in the future.[11][12][13]​​​​​​​

Risk of HFpEF increases with age and additional strong risk factors include hypertension, obesity, diabetes mellitus, atrial fibrillation (AF), and coronary artery disease (CAD).[12][13][14][15]​​​​​​ HFpEF is more common in women (79%), whereas HFrEF is equally prevalent in women and men.[16][17]​​​​​ Comorbidity and multimorbidity is common in patients with HF.[3]​ One study looking at twelve common comorbidities (CAD, AF/flutter, hypertension, peripheral artery disease, cerebrovascular disease, anaemia, obesity, hypercholesterolaemia, diabetes mellitus, rheumatoid arthritis, COPD, and chronic kidney disease) found that 98% to 99% of HF patients had at least one comorbidity, and those with HFpEF had a mean comorbidity burden of 4.3.[18]​ Non-cardiovascular comorbidities such as anaemia, hypothyroidism, renal impairment, chronic lung disease, and liver disease are more prevalent in the HFpEF population.[19]

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