Global Alliance on Heart Failure & Healthy Aging Unveils New Report Projecting Sharp Rise in Heart Failure Mortality Linked to Population Aging and Missed or Late Diagnosis

The report provides illustrative calculations to help quantify the growing burden of heart failure deaths—related to the aging of the population in the next two decades—and its impacts on public health and health systems.

New York, NY – June 10, 2021 – Today, the Global Alliance on Heart Failure and Healthy Aging unveiled a new report, Undiagnosed Heart Failure: A Growing Public Health Risk and Looming Financial Iceberg for Aging Societies. The report examines the link between aging and heart failure, recognizing that a significant portion of heart failure deaths occurs in the older population. By applying predictive data modeling to heart failure trends in G7 countries, EU countries, China, and India—all aging societies—the report underscores the critical need for actions on heart failure, including timely diagnosis, at all stages of the life course. The Alliance is an initiative of the Global Coalition on Aging (GCOA).

“Our projections suggest that America and other societies may face an immense increase in the problem of undiagnosed heart failure, absent heart failure progress and attendant improvements in prevention and treatment,” said Nicholas Eberstadt, PhD, renown political economist and the report’s lead author and researcher. Eberstadt is the Henry Wendt Chair in Political Economy at the American Enterprise Institute. “These calculations build on existing data sets, and when analyzed together, show the urgent need to take action to slow the heart failure death rate across aging societies.”

According to the report: “Undiagnosed heart failure means higher risk of mortality, lower quality of life, and much higher costs of medical care, as these patients are far more likely to end up unexpectedly and perhaps recurrently in emergency departments (EDs) and intensive care units (ICUs).” Compounding the problem, as heart failure prevalence increases with the aging of society, incidence of undiagnosed heart failure are likely to grow as well, resulting in continued gaps in heart failure prevention and treatment.

Furthermore, heart failure mortality is a cause of death for the very oldest of the old. In the United States, nearly three-fifths of the deaths attributed to heart failure in 2015 were to people 85 or older while less than one-in-ten were to people under 65. Yet for older people, heart failure symptoms such as fatigue and shortness of breath are too often conflated with normal signs of aging, preventing timely diagnosis and commencement of treatment for an age group that experiences more heart failure deaths than younger counterparts.

“Ageism too often prevents older adults from accurate and timely diagnosis as heart failure symptoms are too frequently mistaken as normal parts of aging,” said Michael W. Hodin, PhD, CEO of GCOA. “While 2020 and 2021 have created challenging times for us all, what has been starkly brought to light during the pandemic is the critical need to combat inherent ageism across our healthcare systems and society broadly—a focus of the Decade of Healthy Ageing, led by the World Health Organization and United Nations. Heart failure is a clear example of the importance of the pursuit of healthy aging for all, at all stages of life.”

Through illustrative projections—stylized calculations that present “what-if” scenarios for the future—the report quantifies the rough scale of the prospective heart failure problem aging societies face in the coming decades. The report projects the following increase in heart failure mortality between 2015 and 2040:

  • In the U.S., heart failure deaths are projected to soar from 74,000 to 157,000.
  • Heart failure deaths in Italy represent the smallest increase across the countries evaluated, predicted to rise 66%.
  • Heart failure deaths across the EU are projected to increase 83%.
  • In Canada, the increase is projected to be 114%.
  • In Japan, the increase is projected to be 132%.
  • In China, heart failure deaths are predicted to increase 175%.
  • India represents the largest projected increase at 196%.

Based on these sobering projections, GCOA calls for further research across aging societies to delve deeper into the challenges and opportunities of addressing heart failure earlier, including impacts on quality of life, caregiver burden and economic costs. At the same time, these illustrative calculations should serve as a call-to-action for policymakers, healthcare professionals and advocates to change the looming trajectory for those living with or at risk of heart failure.

This new report builds on GCOA’s 2019 report, Best Practices Report on Heart Failure Detection, Diagnosis, Treatment and Care, which offered a clear set of success factors to improve prevention and care for heart failure, highlighted case studies from the United States and Europe, and called out the institutional ageism associated with heart failure.



Melissa Gong Mitchell, Executive Director

Global Coalition on Aging

+1 646 404 1149



The Global Alliance on Heart Failure and Healthy Aging is a multisectoral initiative that aims to reframe heart failure as an urgent priority on the global health agenda in the context of 21st-century aging. While heart failure does increase in prevalence with age, its symptoms, such as fatigue and shortness of breath, must not be mistaken as normal parts of aging or as other co-morbidities associated with older age.

The Alliance consists of experts at the intersection of aging, cardiovascular health, healthcare policy and practice, patient advocacy and communications—all committed to stimulating education, awareness, and policy action that will improve understanding, lead to earlier diagnosis, and mitigate individual, family and economic burdens of this insufficiently recognized and costly disease condition.



The Global Coalition on Aging aims to reshape how global leaders approach and prepare for the 21st century’s profound shift in population aging. GCOA uniquely brings together global corporations across industry sectors with common strategic interests in aging populations, a comprehensive and systemic understanding of aging, and an optimistic view of its impact. Through research, public policy analysis, advocacy, and strategic communications, GCOA is advancing innovative solutions and working to ensure global aging is a path to health, productivity and economic growth. For more information, visit

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