Causes and Risk Factors

What are the causes and risk factors of heart failure?

The causes of heart failure vary with age and family history. However, the causes have one thing in common – they somehow damage the heart muscle and it no longer pumps as well as it should. The risk factors below are general guidelines. For example, not everyone who has had a heart attack will develop heart failure. But heart attack survivors are certainly at higher risk. Any one, or a combination, of these high-risk factors can lead to heart failure.

Coronary Artery Disease and Heart Attack

Your heart muscle has its own blood vessels, called coronary arteries, that carry oxygen-rich blood to the heart walls. What happens when a clogged vessel interrupts blood flow to the heart muscle?

  • A heart attack occurs when a portion of the muscle is permanently damaged. 
  • Not enough oxygen-rich blood flows to the heart tissues. 

The severity of a heart attack depends on how much heart muscle is damaged and how long the muscle went without oxygen. If you have had a heart attack, you are five times as likely to develop heart failure.1

High Blood Pressure

High blood pressure has two primary results:

  • Higher pressure in the vessels due to narrow blood vessels 
  • A heart that must work harder as it pumps against this higher pressure

Your body can tolerate high blood pressure for a while, but over time it can cause: 

  • An enlarged heart 
  • Thickening of the heart muscle 

If you have high blood pressure, you are twice as likely to develop heart failure.1

Valvular Disease

The heart valves control the flow of blood leaving the heart. Sometimes the valves are abnormal: 

  • A narrowing of the valves causes a backup of blood. 
  • Improper closing of the valves allows blood to leak back into the heart. 

Over time, this inefficient blood flow causes physical changes in the heart's size and shape.

Enlarged Heart

When the heart becomes enlarged (called cardiomyopathy), it can weaken the heart muscle and cause it to pump with less force. Causes of an enlarged heart include drug abuse, alcohol abuse, or viral infections.

Other Concerns

Two other factors may contribute to heart failure:

  • Diabetes. Diabetes is linked to obesity, high blood pressure, and coronary artery disease. These conditions also can contribute to heart failure.
  • Alcohol abuse. Too much alcohol can damage the heart muscle and lead to high blood pressure, which is also a risk factor for heart failure.