Hypertension and coronary disease are major risk factors for the incidence and progression of heart failure. These two risk factors frequently coexist, and have additive and synergistic effects that promote both left ventricular remodeling and heart failure in the general population. The relative contributions of these two risk factors to heart failure burden in the community may vary based on age, gender, and race. In general, attribution of heart failure in the community to solely one of these two risk factors is inappropriate. Prevention of both hypertension and coronary disease is important for preventing heart failure in the twenty-first century.