Heart failure is a major and growing public health issue in industrialized countries with aging populations. The article discusses the epidemiology, aetiology, and prognosis of heart failure, highlighting the challenges in defining the condition and the limitations of available data. Prevalence of clinically diagnosed heart failure ranges from 3–20 cases per 1000 population, increasing significantly with age, reaching over 100 cases per 1000 in those aged ≥65 years. Left ventricular systolic dysfunction, a key indicator of heart failure, also increases with age and is more common in men. The annual incidence of heart failure in middle-aged individuals is approximately 0.1–0.2%, doubling with each decade of life, reaching 2–3% in those over 85 years. Heart failure admission rates are rising in industrialized countries, especially among the elderly, with rates ranging from 10–40 admissions per 10,000 population in 1990, increasing to over 75 in those over 65. The cost of managing heart failure in the early 1990s was estimated at 1–2% of total healthcare expenditure, likely an underestimate due to rising hospitalization rates. Heart failure is associated with a 60% mortality rate within five years of diagnosis. Increasing survival after acute myocardial infarction and longer life expectancy in developed nations are expected to increase the overall prevalence of heart failure. Coronary artery disease is the most common cause of heart failure, and trends in its prevalence are likely to lead to an increase in future heart failure cases. The future burden of heart failure is projected to rise significantly, with the prevalence of heart failure due to coronary heart disease expected to increase by 70% in the Netherlands from 1985 to 2010. Heart failure remains a significant public health challenge, with increasing prevalence, mortality, and healthcare costs.Heart failure is a major and growing public health issue in industrialized countries with aging populations. The article discusses the epidemiology, aetiology, and prognosis of heart failure, highlighting the challenges in defining the condition and the limitations of available data. Prevalence of clinically diagnosed heart failure ranges from 3–20 cases per 1000 population, increasing significantly with age, reaching over 100 cases per 1000 in those aged ≥65 years. Left ventricular systolic dysfunction, a key indicator of heart failure, also increases with age and is more common in men. The annual incidence of heart failure in middle-aged individuals is approximately 0.1–0.2%, doubling with each decade of life, reaching 2–3% in those over 85 years. Heart failure admission rates are rising in industrialized countries, especially among the elderly, with rates ranging from 10–40 admissions per 10,000 population in 1990, increasing to over 75 in those over 65. The cost of managing heart failure in the early 1990s was estimated at 1–2% of total healthcare expenditure, likely an underestimate due to rising hospitalization rates. Heart failure is associated with a 60% mortality rate within five years of diagnosis. Increasing survival after acute myocardial infarction and longer life expectancy in developed nations are expected to increase the overall prevalence of heart failure. Coronary artery disease is the most common cause of heart failure, and trends in its prevalence are likely to lead to an increase in future heart failure cases. The future burden of heart failure is projected to rise significantly, with the prevalence of heart failure due to coronary heart disease expected to increase by 70% in the Netherlands from 1985 to 2010. Heart failure remains a significant public health challenge, with increasing prevalence, mortality, and healthcare costs.