As the final common pathway in many forms of cardiovascular disease, heart failure is a major public health problem in the United States. It is the only cardiovascular condition that is increasing in incidence, prevalence, and mortality. The economic impact of heart failure is staggering and is likely to escalate as increasing numbers of people are saved from premature death attributable to coronary heart disease. This article reviews the incidence, prevalence, prognosis, risk factors, and economic impact of this common and usually lethal condition.