Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017

Eur J Prev Cardiol. 2021 Dec 29;28(15):1682-1690. doi: 10.1093/eurjpc/zwaa147.


Aims: To provide the first systematic analysis of the burden and underlying causes of heart failure (HF) in 195 countries and territories from 1990 to 2017.

Methods and results: We collected detailed information on prevalence, years lived with disability (YLDs), and underlying causes of HF from the Global Burden of Disease study 2017. Numbers and age-standardized rates of HF prevalence and YLDs were compared by age, sex, socio-demographic index (SDI), and location. The proportions of HF age-standardized prevalence rates due to 23 underlying causes were also presented. Globally, the age-standardized prevalence and YLD rates of HF in 2017 were 831.0 and 128.2 per 100 000 people, a decrease of -7.2% and -0.9% from 1990, respectively. Nevertheless, the absolute numbers of HF prevalent cases and YLDs have increased by 91.9% and 106.0% from 1990, respectively. There is significant geographic and socio-demographic variation in the levels and trends of HF burden from 1990 to 2017. Among all causes of HF, ischaemic heart disease accounted for the highest proportion (26.5%) of age-standardized prevalence rate of HF in 2017, followed by hypertensive heart disease (26.2%), chronic obstructive pulmonary disease (23.4%).

Conclusion: HF remains a serious public health problem worldwide, with increasing age-standardized prevalence and YLD rates in countries with relatively low SDI. More geo-specific strategies aimed at preventing underlying causes and improving medical care for HF are warranted to reduce the future burden of this condition.

Keywords: Cause; Global; Heart failure; Prevalence; Year lived with disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Global Burden of Disease*
  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Humans
  • Prevalence
  • Quality-Adjusted Life Years
  • Risk Factors