To assess the prevalence of heart failure (HF) in St. Petersburg from 2019 through 2021 based on medical reports.Material and methods Medical records of 146 912 patients with HF who were managed in St. Petersburg from 2019 through 2021 were analyzed. Prevalence of HF was assessed using a standard ICD-10 I 50.x code for this disease. Also, expanded HF coding was used with ICD-10 codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.9, I43.0, I43.1, I43.8, I42.5, I42.7, and I42.8. An additional analysis was performed for mortality from cardiovascular diseases (CVD) as a whole and from HF in particular (n=192 133).Results From 2019 through 2021, the number of both male and female patients with HF increased by 18.14 %. The greatest number of HF patients was in the age group of 75-89 years in 2019-2020 and 60-74 years in 2021, with females prevailing. The HF incidence increased in the age group of 45-59 years with a peak morbidity at age of 60-74 for men and 75-89 for women, which was consistent with the life expectancy of each gender. The expanded coding allowed a more complete presentation of HF prevalence and also to take into account patients with HF caused not only by myocardial infarction or acute cardiac pathology but also by rheumatic heart disease, arterial hypertension, myocarditis, and cardiomyopathies. Cardiovascular mortality significantly increased by 20.1% during the period from 2019 through 2021. The HF prevalence for deceased patients also was steadily increasing during 3 years. Analysis of associated pathology in HF patients revealed, in most cases, hypertension, ischemic heart disease, cerebrovascular diseases, diabetes mellitus, and obesity.Conclusion The increase in HF prevalence and mortality draws attention and calls for managing measures to change the current situation in health care. A registry is required to characterize a typical patient with HF and to present an unbiased picture of HF prevalence. It is also necessary to develop programs for outpatient follow-up of patients in this category and for providing current, highly effective medicines. Education of patients and improving the knowledge of therapists in diagnosis and treatment of HF are most relevant for enhancing the quality and duration of patients' life and for reducing the number of hospitalizations and the HF mortality.