What Is the Survival and Life Expectancy of Heart Failure?
Reviewed by: HU Medical Review Board | Last reviewed: October 2019 | Last updated: February 2021
Outcomes in heart failure (HF) vary greatly.1 Mortality rates, the frequency of death in a specific population during a fixed period of time, can range from 5% to 75%.1 The average life expectancy varies for each stage of HF. Early diagnosis and good treatment adherence can influence a person’s life expectancy. This is due in part to other medical conditions and complications, lifestyle choices, and time of diagnosis.5 This includes preventive lifestyle changes, medications, and the management of any other underlying medical conditions that may help to prolong and improve a person’s quality of life.5 A custom treatment plan can contribute to the best possible outcome.
There are scientific methods available to estimate heart failure survival using information from clinical and laboratory tests, the use of heart failure medications, and a variety of medical devices.1 One analytic tool is called The Seattle Heart Failure Model; it is considered a predictor of survival in heart failure.
Predicting life expectancy
Considerations in predicting survival include age, gender, and body mass index (BMI). The initial cause of heart failure, measurements of ejection fractions (EF), blood pressure (BP), serum sodium, cholesterol levels, hemoglobin, and lymphocytes are also predictive factors of mortality. The classification and staging of heart failure also have clear associations with mortality in The Seattle Heart Failure Model.1 The use of specific medications and devices are also considered in models to evaluate life expectancy because they are prescribed by physicians to improve survival in their patients. The Seattle Heart Failure Model is updated as new heart failure medications or devices come to market.1
American Heart Association
Health statistics are kept by numerous organizations. The American Heart Association compiles an annual Heart Disease and Stroke Statistics Update in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government sources.2-3 It is estimated that more than 6 million people in the US over age 20 have heart failure.3 Nearly half of all U.S. adults, over 121.5 million people, have some type of cardiovascular disease according to the 2019 report which is based on statistics from 2016.3-4 These numbers continue to rise as the population ages.
Heart disease is the number one cause of death in the world and the leading cause of death in the United States.2-3 By 2035, it is anticipated that more than 130 million people will have some form of cardiovascular disease with associated costs to reach over 1 trillion dollars.4 The number of diagnoses of HF present at death and noted on the death certificate has increased to 1 in 8 deaths.3 A 2016 study estimated that about half of people who develop heart failure live beyond 5 years after being diagnosed.5
National Health and Nutrition Examination Survey
NHANES, the National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics and National Heart, Lung, and Blood Institute reports that gender and age are key influential factors in predicting life expectancy after a diagnosis of heart failure.3 This means the lifetime risk of HF is increasing. For example, for people between ages 45 and 95, the lifetime risks for HF are between 20%–45%.3 Gender and racial disparities in HF persist. They influence lifetime risks and projected life expectancy. In the most recent report, the risks for developing HF were 30% to 42% in white males, 20% to 29% in black males, 32% to 39% in white females, and 24% to 46% in black females. Of note, the lower lifetime risk in black males may be attributable to competing risk factors.3
Although the rates of rehospitalization or death were greatest for those previously hospitalized for HF, the length of survival from heart failure in the older population has improved.3 They do differ by HF subtype and stage. The overall 1-year mortality rate is nearly 30%; it has improved only slightly from 2008. Fatality rates, death after hospitalization for HF, were 10.4% at 30-days, 22% at 1-year, and 42.3% at 5-years. There is still a higher rate of death in blacks than whites.3
Traditional factors including diet and lifestyle and elevated BP/BMI impact the risk of developing heart failure and influence life expectancy at all ages. Survival and life expectancy can be enhanced by improved access to quality care.4 The American Heart Association (AHA) promotes seven goals to a healthy lifestyle that can improve the outcome of HF. Called 'AHA’s My Life Check - Life’s Simple 7', it includes:Eat a healthy dietExercise RegularlyAvoid excess weightDon’t smokeManage blood pressure, cholesterol and blood sugar levelsThe outcome doesn’t improve by itself. It takes individual action, improved communication by healthcare providers about treatment, education to address the core health behaviors (smoking, physical activity, diet, and weight), and management of mediating health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health.3-4