UNDERSTANDING THE IMPACT OF heart failure
Behind HF: The John Crofut Story
John is a father and veteran who lives with severe heart failure. This is John's perspective on how he continues to pursue his passions.
Heart failure complications hospitalize more Americans per year than all cancers combined6,7,8
Despite the name, heart failure doesn't mean the heart isn't working at all, it means the heart is unable to pump enough oxygen-rich blood to the body's cells and organs.1 With heart failure, over time the heart tries to compensate by stretching, enlarging and pumping faster to keep up with the body's demands, and it becomes weaker as a result. Heart failure is the consequence of dysfunction within the sarcomere, a complex mechanism of interacting proteins driving heart contraction.
There are two major types of heart failure: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Ejection fraction is a percentage measurement of how much blood the left ventricle pumps out of the heart with each contraction. A healthy heart has an ejection fraction between 50-70%, but someone with HFrEF has an ejection fraction of 40% or less.2
An estimated 6 million people in the U.S. are living with heart failure—and that number is predicted to increase to more than 8 million Americans by 2030.1 Roughly half of those with heart failure have HFrEF, and this population is also expected to grow from 3.1 million in 2020 to 4.0 million in 2032.3 These skyrocketing numbers may be attributed to several factors—an aging population, the epidemics of diabetes and obesity, and medical advances that help people survive heart attacks but face higher risk for heart failure afterwards.2
Heart failure is the leading cause of hospitalization and readmission in people aged 65 and older,5 and each additional hospitalization is associated with an increased risk of death.4 People with heart failure may experience fatigue, shortness of breath during daily activities, edema or swelling in the feet, legs, ankles or stomach, or weight gain. Every day, they may struggle with simple activities like walking, climbing stairs, or carrying things, and managing the disease can be a challenge.
Growing Economic Burden and Health Disparities
The burden of heart failure is not just physical, it is also financial. As of 2020, the cost of care was estimated at $43.6 billion, and is expected to increase to more than $69.7 billion by 2030. This high cost burden is driven in large part by hospitalizations, with an estimated average cost of $17,000 per hospitalization5. With 24% of patients readmitted to the hospital within 30 days, and 50% of patients readmitted within 5 years, heart failure represents a growing public health epidemic.
In the U.S., heart failure disproportionately affects Black patients. Their risk of developing heart failure is approximately 20 times higher than white patients, and their rate of heart failure hospitalization is almost two and a half times higher than the rate for white patients. Black patients with heart failure also experience worse outcomes including higher mortality rates.
Accessing quality medical care is harder for patients who experience socioeconomic hardship, including Black patients. Specialty cardiovascular clinics are frequently located too far from the homes and communities of patients who most need care. Even within health systems, Black patients are less likely to be treated by a cardiologist which can result in delays in diagnosis, or they are referred to cardiologists later in the course of their disease, which translates to poorer clinical outcomes.
At Cytokinetics, we are striving to tackle these disparities through the development of potential medicines that may help make a measurable impact on improving outcomes for all patients.
- Mozaffarian D, et al. Heart disease and stroke statistics-2016 update a report from the American Heart Association. Circulation. 2016.
- Heart failure projected to increase dramatically, according to new statistics. American Heart Association. Available at https://www.heart.org/en/news/2018/05/01/heart-failure-projected-to-increase-dramatically-according-to-new-statistics. Accessed January 1,2023.
- Heart failure. American Heart Association. Available at https://www.heart.org/en/health-topics/heart-failure. Accessed January 1, 2023.
- Types of Heart Failure. American Heart Association. . Accessed August 17, 2020.
- Heart Failure | National Heart, Lung, and Blood Institute (NHLBI). Nhlbi.nih.gov. 2019. Available at: . Accessed March 22, 2019.
- Savarese G, Lund LH. Global Public Health Burden of Heart Failure.Card Fail Rev. 2017;3(1):7-11. doi:10.15420/cfr.2016:25:2
- Malik FI, Hartman JJ, Elias KA, et al. Cardiac myosin activation: a potential therapeutic approach for systolic heart failure. Science. 2011;331(6023):1439-1443.
- Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation. 2013;128(16):e240-e327.
- Kass DA, Solaro RJ. Mechanisms and Use of Calcium-Sensitizing Agents in the Failing Heart. Circulation. 2006;113(2):305-315.
- Psotka MA, Gottlieb SS, Francis GS, et al. Cardiac Calcitropes, Myotropes, and Mitotropes: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;73(18):2345-2353.