Abstract 15469: Projected Heart Failure Incidence in US Adults From 2018-2050

Abstract

Background Heart failure (HF) currently affects 6.7 million people in the US accounting for $40 billion in annual healthcare costs. Projecting future trends in the clinical burden of HF may guide strategic investments in prevention and treatment as well as workforce planning. This study projects the incidence of heart failure in the US population through 2050. Methods: The Cardiovascular Disease (CVD) Policy Model is an established computer-simulation, state-transition model for the US population ages 35-94 years. Age- and sex- specific HF incidence rates were derived from NHLBI pooled cohort studies; the probability of HF hospitalizations associated with coronary heart disease (CHD) or stroke were derived from the National Inpatient Sample and published literature. We applied age- and sex-specific risk factor distributions, incidence, and event rates from 2018 to population projections through 2050 from the US Census. The model estimated absolute number of incident HF cases in subpopulations with CHD (ischemic HF) and without CHD (non-ischemic HF). Results: In 2018, 11% of the US population without HF was aged >=75 years, which compares with 16% projected in 2050. The estimated HF incidence rate was higher in males. The annual incidence of HF in US adults aged 35 to 94 years is projected to increase by 39% from 836,000 in 2018 to 1.2 million by 2050 (Table 1). Most incident HF is estimated to occur in the population without CHD, accounting for three quarters of HF in women and over half in men. Among those with HF, the proportion of the population aged >=75 years was projected to increase from 42% in 2018 to 54% in 2050. Conclusion A large increase in incident HF is expected in coming years, primarily due to an aging population. Most incident HF is estimated to be non-ischemic. Primary prevention, specifically controlling risk factors associated with non-ischemic HF, may offer the greatest opportunity to reduce HF incidence.