Risks for and Causes of Heart Failure 

What is heart failure?

Heart failure is a serious, long-term condition. It’s more likely to happen as you age, but anyone can get it. Heart failure cases have been rising in the U.S. due in part to the aging population.

If you have heart failure, you can still live a full, active life with the proper medical treatment and lifestyle.

Risk factors for heart failure 

Risk factors are traits and lifestyle habits that can increase your chance of heart failure. Most people who get heart failure have (or had) another heart condition first.

Having one or more of these risk factors greatly increases your risk of heart failure:

Coronary artery disease. When cholesterol and fatty deposits build up in the heart’s arteries, less blood can reach the heart muscle. This buildup is known as atherosclerosis. It can cause chest pain (angina). Or, if blood flow becomes totally blocked, a heart attack may result. Blocked arteries can also cause high blood pressure. Over time, high blood pressure can lead to heart failure.

Learn more about coronary artery disease.

High blood pressure. When pressure in the blood vessels is too high, the heart has to pump harder to keep the blood moving. Over time, the heart’s chambers can get larger and weaker, leading to heart failure.

Watch an animation showing how high blood pressure can lead to heart failure, or learn more about high blood pressure.

Type 2 diabetes. People with diabetes tend to get high blood pressure and atherosclerosis from high cholesterol.

Learn more about diabetes and heart disease.

Metabolic syndrome. If you have three or more of these five risk factors, you have metabolic syndrome: 

• Large waistline (abdominal obesity)
• High fasting triglycerides
• Low HDL (good) cholesterol
• High blood pressure 
• High fasting blood sugar 

Metabolic risk factors affect the heart and contribute to developing heart failure. Learn more about metabolic syndrome.

Thyroid problems. Having thyroid problems can affect your heart rate and function.

• Hyperthyroidism can cause a steady increase in heart rate, and the heart muscle thickens over time.   
• Hypothyroidism can cause a slower heartbeat, fluid retention and diastolic dysfunction, a problem with your heartbeat.

Aging.  As you age, your heart can weaken and stiffen. People over 65 are more likely to have heart failure.

Other risk factors include:

• Smoking
• Being obese or overweight
• Alcohol or drug abuse
• Certain types of radiation and chemotherapy

People from certain races are also at higher risk for heart failure. 

• Black people have a about 19% higher risk of getting heart failure than white people. It is sometimes more serious and starts at a younger age than white people. 
  
  
• Research shows that Hispanic people have multiple heart failure risk factors and health care disparities. This suggests increased heart failure risk.

Causes of heart failure

Some factors can directly cause heart failure. All of us lose some blood-pumping ability in our hearts as we age. However, heart failure happens when the heart is stressed by health conditions that either hurt the heart or make it work too hard. Some lifestyle factors can lead to heart failure because they increase your risk of heart conditions linked to heart failure.

Some lifestyle habits that can increase your risk of heart failure include:

• Smoking
• Being overweight or obese
• Eating foods high in saturated fat and cholesterol 
• Not being physically active

Learn what you can do to reduce your risk for heart failure by making lifestyle changes that last.

View an animation of heart failure

Conditions that might lead to heart failure 

If you have heart failure, chances are you have (or had) one or more of the conditions below. And, if you have any of the following, you are at higher risk of getting heart failure.

These conditions usually cause the “wear and tear” that leads to heart failure. Having more than one of these factors greatly increases your risk. You can have some of these conditions without knowing it. Talk to your health care professional to determine if you have any of these conditions.

Past heart attack (myocardial infarction)

A heart attack happens when an artery that supplies blood to the heart muscle becomes blocked. The loss of oxygen and nutrients carried by the blood damages the heart’s muscle tissue. The damaged heart tissue doesn’t contract as well. This weakens the heart’s pumping ability.

Learn more about heart attacks

Abnormal heart valves 

Heart valve problems can be caused by disease, infection (endocarditis) or a defect present at birth. When the valves don’t open or close fully during each heartbeat, the heart muscle has to pump harder to keep the blood moving. If the workload becomes too great, heart failure results.

Learn more about heart valves

Heart muscle disease (dilated cardiomyopathy, hypertrophic cardiomyopathy) or inflammation (myocarditis)

Any damage to the heart muscle increases the risk of heart failure. This could be from: 

• Drug or alcohol use
• Viral or other infections 
• Unknown reasons   

Learn more about cardiomyopathy

Heart defects present at birth (congenital heart defects)

If the heart and its chambers don’t form correctly, the healthy parts must work harder. Whenever parts of the heart must work harder to make up for parts that are not working properly, heart failure results. 

Learn more about congenital heart defects

Other conditions

Less commonly, an otherwise healthy heart may become temporarily unable to keep up with the body’s needs. This can happen in people who have:

• Low red blood cell count (severe anemia): When there aren’t enough red blood cells to carry oxygen, the heart tries to move the cells faster. It can become overworked from the effort.
• Overactive thyroid gland (hyperthyroidism): This condition causes the body to work at a faster pace. The heart can be overworked trying to keep up.
• Abnormal heart rhythm (arrhythmia or dysrhythmia): When the heart beats too fast, too slow or irregularly, it may not be able to pump enough blood to meet the body’s needs. Learn more about arrhythmia.

In these cases, the person may have heart failure symptoms until the underlying problem is identified and treated.

The American Heart Association is here to help. If you live with heart failure, the best thing you can do for your quality of life is: 

• Follow your health care professional’s instructions 
• Make needed changes in your eating patterns, physical activity and lifestyle 

If you are living with heart failure, you’re not alone. More than 6 million Americans are living with heart failure. More than 1 million new cases are diagnosed in adults 55 and older each year. You can manage this condition.

Explore resources on our website and visit the Support Network to connect with others living with heart failure.