Heart Failure Prevalence and Screening

Heart failure represents a critical public health challenge, with a lifetime risk of approximately 1 in 4 for both men and women. The condition affects roughly 7 million Americans, with prevalence expected to rise significantly due to aging populations and increasing risk factors including hypertension, diabetes, and obesity. Heart failure is the leading cause of hospitalization for adults over age 65 years, contributing approximately $30 billion in health care costs annually, with projections reaching $70 billion to $80 billion by 2030.

The economic burden encompasses both common high-frequency costs (hospitalizations, readmissions, multidrug regimens potentially exceeding $30,000 annually) and less frequent but extremely expensive interventions (ablations, device therapies, advanced treatments). Mortality remains substantial, with roughly 20% of patients dying within 90 days post hospitalization and 33% within 1 year. These statistics underscore the urgent need for improved therapeutic approaches and earlier intervention strategies.

Innovative screening programs are being implemented to identify at-risk patients earlier. One health system has developed a systematic approach using 3-question symptom screening for patients over age 60 years during annual wellness visits, followed by b-type natriuretic peptide (BNP) testing for positive screens, and echocardiography for elevated biomarkers. While resource intensive, such programs aim to identify patients with stage A and B heart failure before clinical deterioration, potentially reducing long-term costs and improving outcomes through early guideline-directed medical therapy initiation.