Heart failure is a serious condition that results from various cardiovascular diseases. Recently, we have reported that p53 causes the development of heart failure. Cardiac angiogenesis played an important role in the maintenance of cardiac function as well as the development of cardiac hypertrophy induced by pressure-overload, and upregulated p53 induced the transition from cardiac hypertrophy to heart failure through the suppression of hypoxia inducible factor-1(HIF-1), which regulates angiogenesis in the hypertrophied heart. In addition, p53 is known to promote apoptosis, and apoptosis is thought to be involved in heart failure. Thus, p53 is a key molecule which triggers the development of heart failure from multiple mechanisms.