You can get a death spiral in a game solely concerned with dealing and healing hitpoint damage. Misjudge when to attack or heal, and you end up at disadvantage, where continuing to attack means you run out of hitpoints before your opponent does, while stopping to heal means your opponent continues attacking and you end up in the same situation next turn, minus whatever resource you used for healing. The more mechanics are tied to hitpoints, the more severe and obvious it gets. For example, if moving through dangerous terrain or jumping off a cliff takes hitpoints, getting hit with said disadvantage can mean you're movement options are gradually decreasing too.

This is, in fact, stupidly common in games that use hitpoints. Inducing such a spiral in your enemy is typically how you win in combat.