What JACC’s New Report Tells Us About a Widening Gap in Heart Failure Care

Published On: August 24, 2026Categories: Early Detection & Prevention

Heart failure isn’t heart failure until someone catches it. That should be an obvious statement, but a new report from the American College of Cardiology shows exactly why it isn’t happening — and what it will take to change that.

JACC Cardiovascular Statistics in the United States, 2026, published this March, is the American College of Cardiology’s first attempt at a comprehensive, annually recurring benchmark of U.S. cardiovascular health. It’s a sobering read. After decades of steady progress against heart disease, the report finds that gains are slowing across nearly every major condition — and in some cases, reversing outright.

For anyone working in heart failure detection and management, one finding stands out above the rest.

Mortality Was Improving. Then It Wasn’t.

Age-adjusted heart failure mortality in the United States declined fairly steadily from 1999 to 2011. Since then, the trend has reversed — accelerating sharply during the early COVID-19 pandemic and continuing upward through 2021. The reversal wasn’t evenly distributed. The report found the steepest increases in mortality among adults under 45 and between 45 and 64, men, non-Hispanic Black individuals, people in rural areas, and residents of the South and Midwest — groups that, in many cases, already faced the greatest barriers to timely diagnosis.

The report also shows that heart failure hospitalizations, after declining modestly between 2010 and 2014, have been climbing again — reaching 387 per 100,000 adults by 2021. And the news doesn’t improve much after diagnosis: among Medicare beneficiaries hospitalized for heart failure, 75% die within five years of discharge, regardless of ejection fraction category. Guideline-directed medical therapy remains badly underused even in patients who clearly qualify for it — only 15.3% of newly diagnosed HFrEF patients hospitalized between 2021 and 2023 received full quadruple therapy, despite 82% being eligible.

Taken together, these numbers describe a system that is still largely built to respond to heart failure after it has already become a hospitalization — not to catch it before it does.

The Heart Failure Detection Problem Sits Upstream of the Hospital

It’s worth being precise about what the JACC data is — and isn’t — telling us. This isn’t primarily a story about better hospitals or better drugs. Treatment quality for diagnosed patients has genuinely improved on several dimensions over the past two decades. The unresolved problem is what happens *before* diagnosis: how long it takes for elevated filling pressures to be recognized, and how much cardiac and renal damage accumulates in the meantime.

That gap is largest in exactly the settings where most patients first present with vague, easy-to-miss symptoms — fatigue, mild dyspnea on exertion, occasional swelling — long before an echocardiogram or a specialist referral enters the picture. Primary care is where heart failure either gets caught early or doesn’t get caught until it’s already a hospitalization.

Where the Vivio® System Fits

This is precisely the gap the Vivio® System was built to close. Vivio is an FDA-cleared, non-invasive device that measures left ventricular end-diastolic pressure (LVEDP) — a direct physiological marker of early cardiac dysfunction — in a primary care visit, without the need for an echocardiogram, catheterization, or a cardiology referral just to get an initial read.

The JACC report’s own language calls for “more targeted efforts to improve prevention, detection, and treatment” of cardiovascular disease. Earlier LVEDP detection is a direct answer to that call. A patient identified with elevated filling pressure during a routine primary care visit can start guideline-directed therapy sooner, be referred to cardiology with objective data in hand rather than a vague symptom list, and — ideally — never become one of the rising hospitalization statistics in this report.

The disparities the report documents make this more than a clinical efficiency argument. Rural patients, patients in the South and Midwest, and non-Hispanic Black patients — the populations experiencing the steepest recent mortality increases — are often the same patients with the least convenient access to advanced cardiac diagnostics. A tool that brings LVEDP measurement into the primary care setting has the potential to narrow that gap rather than widen it.

The Data Points to a Detection Problem — and a Detection Solution

Cardiovascular medicine has spent two decades getting better at treating heart failure once it’s found. The JACC report makes clear that finding it earlier is now the harder — and more urgent — problem. That’s the case for rethinking where heart failure detection happens, and for tools like the Vivio System that make early, objective LVEDP measurement accessible at the point of first contact.

Discover more about heart failure, one of the most significant clinical and economic challenges in U.S. healthcare, and how the Vivio System is shifting earlier diagnosis to outpatient settings.

New JACC Report: U.S. Heart Disease Progress Is Stalling

JACC's inaugural 2026 Cardiovascular Statistics report finds hypertension, diabetes and obesity remain widespread, with prevention and treatment gaps persisting. Long-term mortality gains for coronary disease, heart failure, PAD and stroke are slowing or reversing, and disparities by race, geography and income remain stark. The annual benchmark is meant to guide clinical practice and policy and will recur yearly.