Heart Failure Is Increasing in Younger Adults

July 15, 2026

A young man checking his mobile phone while standing in a park during a workout

Heart failure affects 7.7 million Americans. Once seen mostly in older adults with a history of heart disease, it’s becoming increasingly common in younger people.

Eiran Z. Gorodeski, MD, MPH, a cardiologist at University Hospitals Harrington Heart & Vascular Institute, explains what heart failure is, how it’s diagnosed, what’s driving its rise and what the latest treatments can do for patients living with this condition.

What Is Heart Failure?

Despite its name, heart failure doesn’t mean the heart has stopped working. It means the heart can no longer pump enough blood to meet the body’s needs. As a result, every organ and tissue can be affected.

The most common heart failure symptoms are breathlessness and fatigue. In order to diagnose it, doctors look for signs of fluid buildup, including swollen legs, engorged veins in the neck or fluid in the lungs.

Heart failure also causes structural changes in the heart that show on imaging. These can include a weakened or thickened heart muscle, enlarged cardiac chambers or significant disease in the heart’s valves. Doctors also look for congestion in the heart, which can be measured directly with a procedure in a catheterization lab or with a blood test for a hormone called B-type natriuretic peptide (BNP).

“If a patient has all three signals – symptoms like breathlessness or fatigue, signs of structural changes, and elevated congestion in the heart, they fit the picture of someone with heart failure,” says Dr. Gorodeski.

The Connection to Obesity, Diabetes & Carpal Tunnel Syndrome

Until recently, heart failure was a late-stage consequence of heart attacks and coronary disease. And while it still plays a role, the more common cause today is a condition known as cardiometabolic disease.

“We’re seeing many more cases of heart failure where obesity and diabetes are the long-term culprits,” explains Dr. Gorodeski. That’s because both conditions affect the heart by increasing inflammation and forcing it to work harder.

Heart failure isn’t always caused by lifestyle factors or coronary disease. Genetic mutations can also cause changes in the heart muscle, sometimes without symptoms. One of the most common causes is cardiac amyloidosis, the build-up of abnormal proteins in the heart muscle. This causes the heart wall to become thicker and stiffer, interfering with the heart’s ability to pump blood.

Early signs of the condition may include carpal tunnel syndrome or back pain or tingling from spinal stenosis, because the same proteins can build up in ligaments. “We now have effective treatments that can stabilize the disease,” says Dr. Gorodeski. “The earlier it’s detected, the more we can do.”

What Heart Failure Feels Like

Breathlessness is the most common symptom that brings people with heart failure to the doctor. Other common symptoms include:

Fatigue and difficulty with exertion.
Swelling or bloating in the legs or abdomen.
Generalized body aches and pain.

“As heart failure becomes more advanced, it’s not just a disease of the heart – it becomes a total body disease,” Dr. Gorodeski explains. “Levels of inflammation rise, and it can lead to changes in muscle tissue. In very advanced stages, patients start losing muscle mass. They become frail and weak, and things hurt.”

A New Era of Treatment

Just as the understanding of what causes heart failure has evolved, the treatment options have also advanced considerably. For some people with heart failure, a combination of four types of medications can help reduce hospital stays, improve daily life and increase life expectancy:

SGLT-2 inhibitors: Recommended for all types of heart failure, these medications help the kidneys remove excess sugar and fluid from the body, which reduces strain on the heart.
Beta-blockers: A long-established heart failure treatment that reduces strain on the heart.
ARNI (angiotensin receptor-neprilysin inhibitor): A medication that works by blocking harmful hormonal signals that put extra strain on the heart, while also helping the body eliminate excess fluid.
Aldosterone blockers: Medications including spironolactone, eplerenone and finerenone, which block a hormone called aldosterone to help reduce fluid buildup and heart strain.

“These four classes of medications have been proven to help people feel better, live longer and spend less time in the hospital,” Dr. Gorodeski says.

What about GLP-1 weight loss drugs like Wegovy or Zepbound, which are increasingly showing benefits in treating the health impacts of obesity and diabetes? These drugs are also becoming an important part of the treatment toolkit.

Studies show they help heart failure patients even without diabetes, likely by treating the heart directly, reducing weight and improving conditions that worsen heart failure, like sleep apnea and kidney disease.

“There’s increasing evidence that GLP-1 drugs can contribute to fewer heart failure hospitalizations and better outcomes,” says Dr. Gorodeski. “I’ve seen patients’ heart failure stabilize significantly and people just feel a lot better on them.”