Global, Regional, and National Burden of Heart Failure, 1990-2023

Importance Heart failure (HF) is a common condition with substantial geographical variation in its prevalence and underlying etiologies. Consistent and comparable data on the burden of HF within populations are needed to inform health system priorities. Objective To estimate the global burden of HF. Design, Setting, and Participants This cross-sectional study estimates disease burden using Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodologies to integrate multiple information sources. Data come from 204 countries and territories from 1990 to 2023 representing the global population with prevalent HF. Exposure HF and underlying etiologies. Main Outcomes and Measures Estimates with 95% uncertainty intervals (UIs) for the prevalence and years lived with disability (YLDs) for HF by age, sex, location, year, and underlying etiology. Results Globally, there were 56.0 million (95% UI, 49.9-62.2 million) estimated cases of HF in 2023. The estimated prevalence of HF generally increased with age for all locations. While ischemic heart disease and hypertensive heart disease were the 2 most common etiologies globally among older adults, there was substantial variation in etiological pattern by location and age. Congenital heart anomalies and rheumatic heart disease (RHD) were common etiologies in children and young adults, while the proportion of HF due to alcohol use peaked in middle adulthood. Location-specific estimates highlighted regions with higher burden of HF due to specific etiologies, including RHD (south Asia, east Asia, Oceania, southeast Asia, central sub-Saharan Africa, eastern sub-Saharan Africa, southern sub-Saharan Africa, and western sub-Saharan Africa), alcohol use (eastern Europe, Australasia, the Caribbean, and central Europe), and Chagas disease (southern, Andean, tropical, and central Latin America). Conclusions and Relevance Heart failure is a significant global public health burden, and the impact is likely to increase as populations age. However, most HF etiologies can be prevented by interventions that reduce exposure to modifiable risk factors, such as elevated blood pressure, excessive alcohol consumption, and tobacco use. Etiology- and location-specific estimates can provide necessary information for public health officials to determine how best to prioritize interventions to reduce HF disease burden.

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Journal
JAMA Cardiology
Published
2026-09-30
DOI
https://doi.org/10.1001/jamacardio.2026.4068
Primary Topic
Heart Failure Treatment and Management
Type
article
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article

Global, Regional, and National Burden of Heart Failure, 1990-2023

Sarina Ahmadian, Ali Abdolizadeh, Rashid Alavi, Syed Mahfuz Al Hasan et al.
JAMA Cardiology
Heart Failure Treatment and Management
article

Global, Regional, and National Burden of Heart Failure, 1990-2023

Sarina Ahmadian, Ali Abdolizadeh, Rashid Alavi, Syed Mahfuz Al Hasan, Mitra Abbasifard, Khalifah A Aldawsari, Clifford Afoakwah, Tariq Al Bahhawi, Ridwan Olamilekan Adesola, Oluwatobi E Adegbile, Mohammad Aghaali, Shahzaib Ahmed, Shereen M. Aleidi, Waqas Ahmad, Hedayat Abbastabar, Samer O Alalalmeh, Salah Thabit Al Awaidy, Isaac Yeboah Addo, M S Al Zoubi, Olifan Zewdie Abil, Mostafa A. Aboouf, Dariush Abtahi, Koohyar Ahmadzadeh, Fahad Abdulrahman Alhumaydhi, Williams Agyemang‐Duah, Yazan Al Thaher, Asrat Agalu Abejew, KA Adedokun, Mohamed Abouzid, Ali Ahmadi, Muhammad Nadeem Akhtar, Richard Gyan Aboagye, Ahmad Y. Abuhelwa, Fahmi Y. Al-Ashwal, Ahmed Abdelrahman Abdelgalil, Astefanos Al-Dalakta, Muhammad Sohail Afzal, Mushood Ahmed, Mohammed Sa’d ALBashtawy, Tesfaye Birhanu Abebe, Ayman Ahmed, Mohammad Khaled Al Nawayseh, Fares Alahdab, Fadwa Naji Alhalaiqa, O. Abiodun, César Agostinis Sobrinho, Mohammad M. Al-Ahmad, Madineh Abbasi, Samar Abd ElHafeez, Dina Abushanab, Belal Aldabbour, Dmitry Abramov, Nader Al-Dewik, Abdelazeem Algammal, Syed Anees Ahmed, Kishor Adhikari, Prince Owusu Adoma, Mostafa Abdrabou, Percival Delali Agordoh, Sepideh Ahmadi, Fuad Hamdi Abuadas, Shady Abohashem, Feleke Doyore Agide, Catherine O. Johnson, GBD 2023 Heart Failure Collaborators, Ali M. Alfalki, Gasha Salih Ahmed, Makinde Adebayo Adeniyi, Ebenezer Afrifa-Yamoah, Olumide Thomas Adeleke, Irfan Ali, Marjan Ajami, Aanuoluwatimileyin Ibukunoluwa Ajayi, Omar Ali Mohammed Al Zaabi, Auwal Abdullahi, Rafat Ali, Eman Abu-Gharbieh, Mohammad Khursheed Alam, Nadin M. Abdel Razeq, Meriem Abdoun, Suhaib Ahmad, Molalign Aligaz Adisu, Roland Eghoghosoa Akhigbe, Mohammed Algethami, Nurudeen A. Adegoke, Piyush Agrawal, Saheem Ahmad, Mohammad Daud Ali, Mohammed Usman Ali, Rabail Alam, Lisa C. Adams, Muktar Beshir Ahmed, Turki Alanzi, Fahad Alanezi, Sajjad Ahmad, Miracle Ayomikun Adesina, Khalid Alhabib, Danish Ahmad, Moaz Elsayed Abouelmagd, Muayyad Ahmad
article en

Abstract

Importance Heart failure (HF) is a common condition with substantial geographical variation in its prevalence and underlying etiologies. Consistent and comparable data on the burden of HF within populations are needed to inform health system priorities. Objective To estimate the global burden of HF. Design, Setting, and Participants This cross-sectional study estimates disease burden using Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodologies to integrate multiple information sources. Data come from 204 countries and territories from 1990 to 2023 representing the global population with prevalent HF. Exposure HF and underlying etiologies. Main Outcomes and Measures Estimates with 95% uncertainty intervals (UIs) for the prevalence and years lived with disability (YLDs) for HF by age, sex, location, year, and underlying etiology. Results Globally, there were 56.0 million (95% UI, 49.9-62.2 million) estimated cases of HF in 2023. The estimated prevalence of HF generally increased with age for all locations. While ischemic heart disease and hypertensive heart disease were the 2 most common etiologies globally among older adults, there was substantial variation in etiological pattern by location and age. Congenital heart anomalies and rheumatic heart disease (RHD) were common etiologies in children and young adults, while the proportion of HF due to alcohol use peaked in middle adulthood. Location-specific estimates highlighted regions with higher burden of HF due to specific etiologies, including RHD (south Asia, east Asia, Oceania, southeast Asia, central sub-Saharan Africa, eastern sub-Saharan Africa, southern sub-Saharan Africa, and western sub-Saharan Africa), alcohol use (eastern Europe, Australasia, the Caribbean, and central Europe), and Chagas disease (southern, Andean, tropical, and central Latin America). Conclusions and Relevance Heart failure is a significant global public health burden, and the impact is likely to increase as populations age. However, most HF etiologies can be prevented by interventions that reduce exposure to modifiable risk factors, such as elevated blood pressure, excessive alcohol consumption, and tobacco use. Etiology- and location-specific estimates can provide necessary information for public health officials to determine how best to prioritize interventions to reduce HF disease burden.

JAMA Cardiology
Suez Canal University (EG), Tulane University (US), University of Jordan (JO), Australian National University (AU), East Tennessee State University (US), Poznan University of Medical Sciences (PL), Edith Cowan University (AU), California Institute of Technology (US), King Abdulaziz City for Science and Technology (SA), Roswell Park Comprehensive Cancer Center (US), Loma Linda University Medical Center (US), Huntington Medical Research Institutes (US), The University of Sydney (AU), Cleveland Clinic (US), Mayo Clinic (US), St. George's University (GD), Harvard University (US), University of Lahore (PK), Jimma University (ET), SRM Institute of Science and Technology (IN), Johns Hopkins University (US), Cairo University (EG), University of Education, Winneba (GH), University of Liverpool (GB), University of Khartoum (SD), Philadelphia University (JO), Tribhuvan University (NP), University of South Carolina (US), Qassim University (SA), Queensland University of Technology (AU), Al Ain University (AE), Tabriz University of Medical Sciences (IR), Flinders University (AU), Shahrekord University of Medical Sciences (IR), Rawalpindi Medical University (PK), Aligarh Muslim University (IN), Chinese University of Hong Kong (HK), Islamic University of Gaza (PS), University of Ibadan (NG), Ajman University (AE), East Carolina University (US), University of Canberra (AU), Jouf University (SA), Bowen University (NG), University of Washington (US), University of Zurich (CH), Washington University in St. Louis (US), Queen's University (CA), University of Health and Allied Sciences (GH), Loma Linda University (US), King Faisal Specialist Hospital & Research Centre (SA), Gower College Swansea (GB), King Saud University (SA), University of Sharjah (AE), Babcock University (NG), Al al-Bayt University (JO), Institute for Health Metrics and Evaluation (US), UNSW Sydney (AU), Swansea University (GB), University Ferhat Abbas of Setif (DZ), Massachusetts General Hospital (US), University of Ha'il (SA), Bowen University Teaching Hospital (NG), University of Jeddah (SA), Instituto Politécnico da Guarda (PT), National Nutrition and Food Technology Research Institute (IR), African Institute for Mathematical Sciences (RW), Ambo University (ET), University of Human Development (IQ), Ministry of Health (OM), Federal Medical Centre (NG), Woldia University (ET), University of Science and Technology, Sana’a (YE), Al-Ayen Iraqi University (IQ), Wachemo University, Federal University Wukari, Advanced Diagnostic and Interventional Radiology Research Center, FMH College of Medicine & Dentistry (PK), Metro North Hospital and Health Service (AU), Sultan Qaboos University (OM), Shahid Beheshti University (IR), Hamad Medical Corporation (QA), University of Colorado Anschutz Medical Campus (US), Abasyn University (PK), Lebanese American University (LB), Bahir Dar University (ET), Shahid Beheshti University of Medical Sciences (IR), Jamia Millia Islamia (IN), Qatar University (QA), Qom University of Medical Science and Health Services (IR), Technical University of Munich (DE), University of Cincinnati (US), University at Buffalo, State University of New York (US), University of Maiduguri (NG), Tehran University of Medical Sciences (IR), Imam Abdulrahman Bin Faisal University (SA), University of Missouri (US), Cardiff University (GB), Alexandria University (EG), Rafsanjan University of Medical Sciences (IR), University of Management and Technology (PK), Jazan University (SA), Bayero University Kano (NG), University of Colorado Denver (US), Stanford University (US)
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Heart Failure Treatment and Management
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