The emerging epidemic of heart failure with preserved ejection fraction

A. Afşin Oktay, Jonathan D. Rich, Sanjiv J. Shah*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

236 Scopus citations


Heart failure with preserved ejection fraction (HFpEF), which currently represents approximately 50 % of heart failure (HF) cases, is common and associated with high morbidity and mortality. Understanding the epidemiology of HFpEF has been difficult due to the challenges in HFpEF diagnosis and the heterogeneous etiologies and pathophysiologies that underlie HFpEF. Nevertheless, several high-quality epidemiology and observational registry studies of HFpEF demonstrate that an increasing prevalence of HFpEF in both the outpatient and inpatient settings, coupled with a lack of evidence-based effective treatments for HFpEF, is resulting in an emerging epidemic of HFpEF. In this review, we discuss the emerging HFpEF epidemic, focusing on: (1) reasons for the rising prevalence of HFpEF; (2) the abnormalities in cardiac structure and function that dictate the transition from risk factors to HFpEF; (3) novel HFpEF mechanisms that may underlie the increase in HFpEF prevalence; (4) prognosis of HFpEF; and (5) risk prediction in HFpEF. We conclude with 10 unanswered questions on HFpEF epidemiology that will be important areas for future investigation.

Original languageEnglish (US)
Pages (from-to)401-410
Number of pages10
JournalCurrent heart failure reports
Issue number4
StatePublished - Dec 2013


  • Diastolic heart failure
  • Epidemiology
  • Pathophysiology
  • Prognosis
  • Risk estimation

ASJC Scopus subject areas

  • Emergency Medicine
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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