Roughly 64 million people worldwide live with heart failure. It is the most common reason for hospital admission in adults over 65 — and one of the leading causes of cardiovascular death.
The good news: heart failure usually develops over years, and most major risk factors are modifiable. Knowing your risk early lets you act before symptoms appear.
What is heart failure?
Heart failure means the heart can no longer pump enough blood to meet the body's needs. Two main forms exist: HFrEF (reduced ejection fraction, EF < 40 %) and HFpEF (preserved ejection fraction with impaired filling). Both share most modifiable risk factors.
Early stages (NYHA I–II) are often silent — this calculator helps frame your risk before symptoms develop.
The most important risk factors
1. High blood pressure (hypertension)
The number-one cause. Chronically elevated pressure forces the heart to pump against extra resistance — the left ventricle thickens (hypertrophy) and stiffens over time. Lowering systolic BP by 10 mmHg cuts heart failure risk by 28 % (Ettehad, Lancet 2016).
2. Coronary artery disease and prior heart attack
Narrowed coronary arteries starve the heart muscle of oxygen. After a heart attack a scar forms — that region can no longer contribute. Around 40 % of heart failure cases trace back to coronary disease.
3. Diabetes mellitus
Doubles the risk independently of other factors. High glucose damages small cardiac vessels and produces a specific "diabetic cardiomyopathy".
4. Overweight and obesity
For every 1-point BMI increase above 25, heart failure risk rises by about 5 % (Framingham Heart Study, JAMA 2002). Obesity (BMI ≥ 30) doubles the risk.
5. Smoking
Increases risk by about 45 % and accelerates coronary disease. Risk drops markedly after 5 years of abstinence.
6. Chronic kidney disease
Heart and kidney are tightly coupled (cardiorenal syndrome). An eGFR below 60 ml/min is an independent risk factor.
7. Physical inactivity
Less than 150 min/week of moderate exercise raises risk substantially. Regular endurance activity is among the strongest preventive measures.
Calculate your 10-year risk
7 risk factors, instant categorization — anonymous, no sign-up.
Open the heart failure risk calculator →Recognize early symptoms
Watch for these warning signs — they often appear gradually:
- Shortness of breath on exertion — climbing stairs is harder than usual
- Swollen ankles or legs, especially in the evening — sock imprints
- Nighttime dry cough or breathlessness lying flat
- Rapid fatigue and reduced exercise tolerance
- Sudden weight gain (more than 2 kg / 4 lbs in days — fluid retention)
- Palpitations, irregular heartbeat, or dizziness
Several symptoms together are an urgent warning — see a doctor immediately.
What the score means
| Score | Category | Recommendation |
|---|---|---|
| 0 – 3 | low | Maintain lifestyle, screening every 2–3 years |
| 4 – 7 | moderate | Actively reduce risk factors, annual check-up |
| 8 – 12 | high | See your GP; consider ECG/echocardiogram |
| ≥ 13 | very high | Cardiology evaluation recommended |
What actually works — evidence-based
- Blood pressure under 130/80 mmHg: cuts risk by up to 30 % (SPRINT-HF, NEJM 2017).
- 150 min/week endurance exercise: better pump function, lower incidence.
- Mediterranean diet (PREDIMED): −30 % cardiovascular events.
- Weight loss with BMI ≥ 30: every 5 % loss measurably improves cardiac function.
- Smoking cessation: after 5 years risk approaches non-smoker levels.
- Diabetes control: HbA1c < 7 %; SGLT2 inhibitors reduce hospitalization by 30 %.
Related calculators
Heart failure shares risk factors with other cardiovascular outcomes. Also check your cardiovascular risk, your stroke risk, and read how to measure blood pressure correctly.
Bottom line
Heart failure is common, serious — and largely preventable. Tackling hypertension, diabetes, excess weight, and inactivity early cuts your risk substantially. Run the heart failure risk calculator and discuss elevated values with your physician.