Heart Failure Causes and Risk Factors
Long-term, or chronic, heart failure is often caused by other medical conditions that damage or overwork your heart. Sudden, or acute, heart failure can be caused by an injury or infection that damages your heart, a heart attack, or a blood clot in your lung.
To understand heart failure, it helps to know how the heart works. The right side of your heart gets oxygen-low blood from your body. It pumps the blood to your lungs to pick up oxygen. The left side of your heart pumps oxygen-rich blood to the rest of your body.
What causes left-sided heart failure?
Left-sided heart failure is more common than right-sided heart failure. There are two types of left-sided heart failure, each based on how well your heart pumps. This measurement is called the ejection fraction. The Diagnosis section has more information about ejection fraction.
- In heart failure with reduced ejection fraction (HFrEF), the left side of your heart is weak and can’t pump enough blood to the rest of your body. Chronic conditions that damage or weaken the heart muscles are the main cause of heart failure with reduced ejection fraction. For example, coronary heart disease or a heart attack can prevent your heart muscle from getting enough oxygen. Other causes of this type of heart failure include faulty heart valves, an irregular heartbeat, or heart diseases that you are born with or .
- In heart failure with preserved ejection fraction (HFpEF), the left side of your heart is too stiff to fully relax between heartbeats. That means it can't fill up with enough blood to pump out to your body. High blood pressure and other conditions that make your heart work harder are the main causes of heart failure with preserved ejection fraction. Conditions that stiffen the chambers of the heart such as obesity and diabetes are also causes of this type of heart failure. Over time, your heart muscle thickens to adapt, which makes it stiffer.
The Diagnosis section includes more about heart failure with preserved or reduced ejection fraction and how doctors diagnose it.
What causes right-sided heart failure?
Over time left-sided heart failure can lead to right-sided heart failure.
In right-sided heart failure, your heart can't pump enough blood to your lungs to pick up oxygen. Left-sided heart failure is the main cause of right-sided heart failure. That’s because left-sided heart failure can cause blood to build up on the left side of your heart. The build-up of blood raises the pressure in the blood vessels that carry blood from your heart to your lungs. This is called pulmonary hypertension, and it can make the right side of your heart work harder.
Congenital heart defects or conditions that damage the right side of your heart such as abnormal heart valves can also lead to right-side heart failure. The same is true for conditions that damage the lungs, such as chronic obstructive pulmonary disease (COPD).
What raises my risk for heart failure?
Many things can raise your risk of heart failure. Some things you can control, such as your lifestyle habits, but many others are out of your control, including your age, race, or ethnicity. Your risk of heart failure goes up if you have more than one of the following.
- Aging can weaken and stiffen your heart. People 65 years or older have a higher risk of heart failure. Older adults are also more likely to have other health conditions that cause heart failure.
- Family history of heart failure makes your risk of heart failure higher. Genetics may also play a role. Certain changes, or , to genes can make your heart tissue weaker or less flexible.
- Unhealthy lifestyle habits, such as an unhealthy diet, smoking, using cocaine or other illegal drugs, heavy alcohol use, and lack of physical activity, increase your risk of heart failure.
- Heart or blood vessel conditions, serious lung disease, or infections such as HIV or SARS-CoV-2 raise your risk. This is also true for long-term health conditions such as obesity, high blood pressure, diabetes, sleep apnea, chronic kidney disease, anemia, disease, or iron overload. Cancer treatments such as radiation and chemotherapy can injure your heart and raise your risk as well. Atrial fibrillation, a common type of irregular heart rhythm, can also cause heart failure.
- Black and African American people are more likely to have heart failure than people of other races, often have more serious cases of heart failure and experience heart failure at a younger age.
Heart failure is common in both men and women, although men often develop heart failure at a younger age than women. Women more commonly have heart failure with preserved ejection fraction (HFpEF), which is when the heart does not fill with enough blood. Men are more likely to have heart failure with reduced ejection fraction (HFrEF), [DEF]. Women often have worse symptoms than men.
Can heart failure be prevented?
You can take the following steps to lower your risk of developing heart failure. The sooner you start, the better your chances of preventing or delaying the condition.
- Adopt a heart-healthy lifestyle. Choosing heart-healthy foods, aiming for a healthy weight, getting regular physical activity, quitting smoking, and managing stress can help keep your heart healthy.
- Limit or avoid alcohol and do not use illegal drugs.
- Work with your healthcare provider to manage conditions that raise your risk of heart failure, such as diabetes, high blood pressure, and obesity.