Heart Failure 101

Heart failure amongst Southeast Asians patients had the
highest burden of comorbidities, particularly diabetes
mellitus and chronic kidney disease, despite being
younger than Northeast Asian participants1.

What is Heart Failure?

Heart failure occurs when a heart is just not working quite as well as it should. It doesn’t mean that the individual has had a heart attack, or that their heart has stopped working - more that it can’t pump blood around the body as effectively as is needed.

What is more worrying, as seen in the Malaysian HF registry, is that 56% of patients that were admitted were in NYHA class III/IV and 14% required coronary care or intensive care on admission2.

Heart failure is not limited to the elderly

While heart failure is more common in older people, that doesn't mean you shouldn't worry if you're young.

In fact, some people get heart failure at a younger age. Heart failure can be the result of numerous other conditions which could affect the heart.

That is why it is important to be aware of the symptoms and risk factors that can lead to heart failure.


HF affects 64 million people worldwide3.




Of all adults aged 40 and older, 1 in 5 will develop heart failure in their lifetime4.




The average age of heart failure patients in Malaysia is 602.



HF is the leading cause of hospitalisations in people over the age of 655.



HF is as deadly as some of the most common types of cancer in both men (prostate and bladder cancer) and women (breast cancer)6.


Signs & Symptoms of Heart Failure

Heart failure is not easy to spot. Most of its symptoms are non-specific and hard to differentiate from other health conditions. This makes early detection very challenging11,12.

Here are some of the common symptoms that you should look out for:

Shortness of breath11,12

Swelling - notably in the ankles, feet or lower legs11,12

Tiredness or fatigue11,12

Heart rate - especially if they feel their heart is racing or throbbing11,12

Lack of appetite and nausea11,12

Persistent coughing or wheezing11,12

If you are experiencing any of these symptoms, please see a doctor for advice immediately.

We have also created a useful tool to help you track your symptoms.


How do you get heart failure?

Pinpointing the exact causes of heart failure isn’t always straightforward. Sometimes, there can be several contributing factors that combine and lead to the condition.

Here are some of the common risk factors that can increase your chances of developing heart failure1,7,8,9:




Being over the age of 60




Coronary heart disease or previous heart attack
















Excessive alcohol consumption



A recent study showed that the general public are largely unaware of the main causes of heart failure. Two out of three people did not recognise diabetes, high blood pressure and coronary heart disease as the leading risk factors10.

In Malaysia, heart failure patients also commonly live with other health conditions, such as hypertension (71%), diabetes (59%), ischaemic heart diseases (55%), and chronic kidney disease (30%), which can contribute to poorer outcomes2.


  1. MacDonald et al. J Am Heart Assoc. 2020;9: e012199. DOI: 10.1161/JAHA.119.012199
  2. NHAM MY HF Registry 2021 (interim data)
  3. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet 390 (10100): 1211-1259.
  4. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002;106(24):3068-3072.
  5. Cowie MR, Anker SD, Cleland JGF, et al. Improving care for patients with acute heart failure: before, during and after hospitalization. ESC Heart Fail. 2014;1(2):110-145.Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014;63(12):1123-1133.
  6. Mamas MA, Sperrin M, Watson MC, et al. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Fail. 2017;19(9):1095–1104.
  7. American Heart Association. Causes of heart failure. Available from: https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure. Accessed 18 September 2020.
  8. Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017 Apr;3(1):7-11.
  9. He J, Shlipak M, Anderson A, et al. Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study. J Am Heart Assoc. 2017;17;6(5):e005336
  10. AstraZeneca PLP. Data on File. ID: REF – 74964. March 2020
  11. NHS. Symptoms of heart failure. Available online at: https://www.nhs.uk/conditions/heart-failure/symptoms/. Last accessed August 25 2020.
  12. Mayo Clinic. Symptoms of Heart Failure. Available online at: https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142. Last accessed August 25 2020.