Heart failure is often caused by heart and blood vessel problems that are more common as people get older. A person can have more than one cause of heart failure at the same time.

Types of Heart Failure

Heart failure can affect the right side, the left side, or both sides of the heart. There are two main types of heart failure. These types are based on how much blood the left ventricle (a main pumping chamber of the heart) pushes out to the body. This amount is called the ejection fraction.

1. Heart failure with reduced ejection fraction [HFrEF) happens when the heart muscle is weak and cannot pump strongly enough. In this type, the left ventricle pumps out less than 40 percent of the blood inside it.
2. Heart failure with preserved ejection fraction [HFpEF] happens when the heart muscle is stiff and cannot relax well between beats. Because it cannot relax fully, it does not fill with enough blood to pump out. In this type, the ejection fraction is usually normal (50 percent or higher), but the heart still does not work as it should.

How Common is Heart Failure

Heart failure affects more than 6 million people in the United States. More than 1 million new cases are diagnosed each year. About 14 percent of men and 13 percent of women over age 80 have heart failure.

Heart failure is the most common reason people age 65 and older are admitted to the hospital. About 20 percent of people who are hospitalized for heart failure return to the hospital within 30 days because they do not feel better or their symptoms get worse. Up to 50 percent return to the hospital within 6 months for the same problem.

Among older adults with heart failure:

• About 60 percent have at least five other long-term health conditions.

• More than half have some level of disability.

End of Life Considerations

About two-thirds of people who die from heart failure are age 75 or older.

Healthcare professionals should start talking early about comfort, symptom relief, and end-of-life care for people with heart failure. These conversations help the care team understand what matters most to the person and what their wishes are.

These discussions should happen again over time, especially if the person’s condition changes.

Last Updated April 2026