Risk Factors for Heart Failure

A risk factor is something that increases your likelihood of getting a disease or condition.

It is possible to develop heart failure with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing heart failure. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

The heart has a normal decrease in function as we age. This decrease is generally not enough to cause problems but can increase the risk of developing heart disease. As a result, heart disease is more common in people who are aged 65 years or older. Although heart failure is more common in men, both men and women can develop heart failure.

African Americans have higher rates of high blood pressure, diabetes, and obesity. As a result, African Americans are more likely to develop heart failure, have earlier symptoms, and die from heart failure more than any other ethnic group.

Other risk factors for heart failure include:

Conditions That Damage or Weaken the Heart

Having certain health conditions can put you at an increased risk for heart failure. These conditions force the heart to work harder to overcome heart muscle weakness or damage.

Heart, blood vessel, and lung conditions can make the heart to work harder than it should. Conditions linked to heart failure include:

  • Coronary artery disease: (CAD) Cholesterol and fat can build up in the arteries that supply the heart with blood. This build-up narrows the blood vessels, causing reduced blood flow to the heart muscle.
  • High blood pressure: Narrowing and hardening of the arteries reduces systemic blood flow and increases blood pressure.
  • Severe lung conditions: Impaired lung function, such as chronic obstructive pulmonary disease (COPD), affect the body's ability to exchange oxygen efficiently. This puts extra strain on the heart to deliver blood and oxygen to the lungs. This also includes infections that affect lung function, such as pneumonia.
  • Valvular heart disease: The four valves of the heart keep blood flowing efficiently and in the correct direction. Damage or infection affecting the valves may cause leaking between heart chambers which affects heart efficiency.
  • Cardiomyopathy: The heart muscle may become damaged due to infection, chronic alcohol abuse, certain chemotherapy drugs, cocaine, or scarring. The damage results in inadequate contraction of the heart muscle.
  • Heart arrhythmias: Are abnormal heart rhythms. If the heart beats too slowly it cannot adequately pump blood through the body. If it beats too quickly, it may not allow the heart to fill with the adequate amount of blood the body needs between heart beats.
  • Congenital heart defects: Birth defects of the heart muscle or valves.

Metabolic conditions can cause changes that increase pressure on the heart such as high cholesterol, high blood pressure, and elevated heart rate. Conditions associated with increased risk of heart failure include:

  • Diabetes: People who have diabetes are at increased risk of developing heart disease. They often have other conditions that increase their risk of heart disease, like high cholesterol and increased weight.
  • Metabolic syndrome: This condition is marked by elevated blood pressure, cholesterol, blood glucose, and body weight. Excess weight centered around the midsection is of particular concern.
  • Obesity: Extra body weight causes the heart to work harder in order to circulate blood and nutrients throughout the body. Obesity is also linked to other heart-related risk factors, such as high blood pressure and sleep apnea.
  • Hyperthyroidism: This condition, caused by an overactive thyroid gland, increases the metabolic rate in the body. The increased levels of thyroid hormone signal the heart to pump faster and harder to supply the body with blood, causing strain.

Other conditions associated with increased risk of heart failure include:

  • Anemia: Red blood cells carry oxygen throughout the body. When the number of red blood cells is reduced, the heart must circulate blood more frequently to supply enough oxygen to the tissues.
  • Kidney disorders: Impaired kidney function elevates blood pressure.
  • Psychological disorders: It is not known how depression, anxiety, and heart failure are linked, but psychological problems do affect overall mental and physical well being. Fatigue or disinterest can lead you to make poor decisions about your health, such as ignoring treatment plans that reduce your risk of heart diseases.

Specific Lifestyle Factors

These lifestyle factors may cause heart muscle damage, increasing your risk of heart failure:

  • Smoking
  • Excessive alcohol consumption
  • Long-term use of anabolic steroids


African-Americans and heart disease, stroke. American Heart Association website. Available at:
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Updated August 22, 2017. Accessed September 15, 2017.
Causes and risks for heart failure. American Heart Association website. Available at:
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Updated May 8, 2017. Accessed September 15, 2017.
Felker CM, Thompson RE, Hare JM, et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000;342(15):1077-1084.
Heart failure with reduced ejection fraction. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated September 1, 2017. Accessed September 15, 2017.
Who is at risk for heart failure? National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/hf/atrisk. Updated June 22, 2015. Accessed September 15, 2017.
1/18/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Emdin CA, Odutayo A, Wong CX, Tran J, Hsiao AJ, Hunn BH. Meta-analysis of anxiety as a risk factor for cardiovascular disease. Am J Cardiol. 2016;118(4):511-519.
Last reviewed September 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 1/18/2017

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