4. Epidemiology
The lifetime risk of developing HF is 20% for Americans ≥40 years of age. In the United States, HF incidence has largely remained stable over the past several decades, with >650,000 new HF cases diagnosed annually. HF incidence increases with age, rising from approximately 20 per 1,000 individuals 65 to 69 years of age to >80 per 1,000 individuals among those ≥85 years of age. Approximately 5.1 million persons in the United States have clinically manifest HF, and the prevalence continues to rise. In the Medicare-eligible population, HF prevalence increased from 90 to 121 per 1000 beneficiaries from 1994 to 2003. HFrEF and HFpEF each make up about half of the overall HF burden. One in 5 Americans will be >65 years of age by 2050. Because HF prevalence is highest in this group, the number of Americans with HF is expected to significantly worsen in the future. Disparities in the epidemiology of HF have been identified. Blacks have the highest risk for HF. In the ARIC (Atherosclerosis Risk in Communities) study, incidence rate per 1,000 person-years was lowest among white women, and highest among black men, with blacks having a greater 5-year mortality rate than whites. HF in non-Hispanic black males and females has a prevalence of 4.5% and 3.8%, respectively, versus 2.7% and 1.8% in non-Hispanic white males and females, respectively.