Prevalence and mortality rate of heart failure across demographic groups in the United States: 2001-2020.

Background: Heart failure (HF) is a serious, difficult-to-diagnose condition. Tracking its evolving burden using survey data is key to developing strategies to reduce its impact. Methods: We use NHANES and CDC-WONDER to determine prevalence and death rates in the U.S. population between 2001 and 2020 across age, sex, and race/ethnicity. We also estimated a crude mortality-to-prevalence ratio (proxy CFR)as a descriptive measure of lethality across demographic groups. Results: Age-adjusted HF prevalence rates for both males and females increased from 2001 to 2020, with males consistently having higher rates. By 2020, the age-adjusted mortality rate was 32.08 per 100,000 males and 25.69 per 100,000 females. HF prevalence increased across all racial groups (from 1.73 % to 1.92 %, 2.47 % to 2.8 %, and 3.68 % to 4.14 % for Hispanic, White, and Black, respectively). Non-Hispanic Blacks showed a steeper rise in both crude and age-adjusted mortality rates from 2001 to 2020, while the proxy CFR for non-Hispanic Whites remained highest among all groups both in 2001 (23.95/2.47 = 9.70) and in 2020 (29.29/2.80 = 10.46). Conclusions: We observe rising trends in both prevalence and mortality across all groups. While the absolute burden is highest in Whites, the increase in HF rates among Blacks and the higher mortality rates in males highlight the need for targeted interventions. The findings underscore the importance of continued surveillance and considering multiple metrics (absolute numbers, rates within groups, and proxy CFR) to address HF's burden in diverse populations.