Risk Factors

Nearly 6 million Americans are living with heart failure. About 670,000 new cases of heart failure are diagnosed each year. Although there has been a dramatic increase over the last several decades in the number of people who suffer from heart failure, survival rates have greatly improved.

Coronary artery disease, heart attack, and high blood pressure are the main causes and risk factors of heart failure. Other diseases that damage or weaken the heart muscle or heart valves can also cause heart failure. Heart failure is most common in people over age 65, African-Americans, and women.

Age

Heart failure risk increases with advancing age. Heart failure is the most common reason for hospitalization in people age 65 years and older.

Gender

Men are at higher risk for heart failure than women. However, women are more likely than men to develop diastolic heart failure (a failure of the heart muscle to relax normally), which is often a precursor to systolic heart failure (impaired ability to pump blood).

Ethnicity

African-Americans are more likely than Caucasians to develop heart failure before age 50 and to die from the condition.

Family History and Genetics

People with a family history of cardiomyopathies (diseases that damage the heart muscle) are at increased risk of developing heart failure. Researchers are investigating specific genetic variants that increase heart failure risk.

Diabetes

People with diabetes are at high risk for heart failure, particularly if they also have coronary artery disease and high blood pressure. Some types of diabetes medications, such as rosiglitazone (Avandia) and pioglitazone (Actos), have been associated with heart failure. Chronic kidney disease caused by diabetes also increases heart failure risk.

Obesity

Obesity is associated with both high blood pressure and type 2 diabetes, conditions that place people at risk for heart failure. Evidence strongly suggests that obesity itself is a major risk factor for heart failure, particularly in women.

Lifestyle Factors

Smoking, sedentary lifestyle, and alcohol and drug abuse can increase the risk for developing heart failure.

Medications Associated with Heart Failure

Long-term use of high-dose anabolic steroids (male hormones used to build muscle mass) increases the risk for heart failure. The drug itraconazole (Sporanox), used to treat skin, nail, or other fungal infections, has occasionally been linked to heart failure. The cancer drug imatinib (Gleevec) has been associated with heart failure. Other chemotherapy drugs, such as doxorubicin, can increase the risk for developing heart failure years after cancer treatment. (Cancer radiation therapy to the chest can also damage the heart muscle.)

Review Date: 05/04/2011
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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