HF patterns in the United States have changed substantially over the past three decades. A study in the Journal of the American College of Cardiology assessed national trends in HF prevalence, major risk factors, and health outcomes from 1988 to 2023.

The analysis included 83,552 adults aged ≥20 years, of whom 3,078 reported HF. The study evaluated the prevalence of obesity, elevated BP, impaired glucose homeostasis, hypercholesterolemia, CKD, and prior MI. It also assessed trends in cardiovascular mortality, all-cause mortality, noncardiovascular mortality, self-reported health, physical functioning, and work-related limitations.

Crude HF prevalence increased from 2.1% in 1988 to 3.0% in 2023, reflecting a rise from 3.3 million to 7.4 million adults. Age-standardized HF prevalence remained stable (2.9% to 3.0%). Among adults with HF, obesity increased from 32.5% to 60.4%, impaired glucose homeostasis from 48.6% to 69.2%, diabetes from 21.2% to 36.2%, and CKD from 38.6% to 52.3%. Elevated BP declined from 80.7% to 49.1%, hypercholesterolemia from 71.5% to 22.6%, and prior MI from 59.3% to 42.1%.

These shifts were accompanied by reductions in cardiovascular and all-cause mortality, paralleled by a rise in noncardiovascular mortality. Self-reported health and physical functioning improved, while work-related impairments persisted.