Cardiology Groups Position HF as Preventable Disease

Medscape

2 days ago

Two leading cardiology groups have joined forces to position heart failure as a preventable condition, encouraging clinicians to recognize and manage key risk factors decades before symptoms appear.
The joint statement, from the Heart Failure Society of America (HFSA) and the American Society for Preventive Cardiology (ASPC), calls the prevention of heart failure a lifelong endeavor that begins with the identification of early risk factors and lifestyle modification and extends throughout the care of patients with advanced disease. In this way, clinicians can help lessen hospitalizations, enhance patients' quality of life, and improve survival of the condition, which affects nearly 7 million American adults — according to the US CDC — and leads to more than 450,000 deaths per year in this country.
The lifetime risk for developing heart failure is substantial, with approximately 1 in 4 Americans expected to develop the disease under current trends. While advances in medications and device-based therapies have improved care, mortality from the condition continues to rise and is projected to reach more than 11 million Americans by 2050, according to the HFSA.
Clinical diagnostics such as blood and urine tests can reveal early signs of stress on the heart and kidneys, according to the new statement. These tests will allow patients to benefit from timely intervention, often with therapies that not only help manage symptoms but that can slow or reverse progression of the disease.
Martha Gulati, MD, MS
'The new HFSA–ASPC statement on heart failure prevention is both timely and urgently needed,' said Martha Gulati, MD, MS, a co-author of the document and associate director of the Preventive and Cardiac Rehabilitation Center at the Smidt Heart Institute in Los Angeles. 'With more than 6 million Americans living with heart failure — and numbers projected to rise sharply in the coming decades — we must shift our focus from treating advanced disease to preventing it altogether. This statement provides a roadmap for clinicians and healthcare systems to address risk factors early, reduce disparities, and change the trajectory of this growing public health crisis.'
Gulati called the statement 'a wake-up call' for clinicians who 'need to break down silos' between preventive cardiology and care for heart failure and create seamless strategies to identify and manage risks earlier. 'What we are witnessing is the beginning of a paradigm shift in how we approach cardiovascular care—one that moves us from episodic, siloed disease management to proactive, whole-person care anchored in prevention,' she said.
Spurring Integrated Care
A goal of the new initiative is greater reimbursement for preventive services — including cardiac rehabilitation, nutrition counseling, and behavioral support — which have historically been underutilized yet are critical for sustainable health improvement. The shift also promotes integrated models of care, which connect primary care with cardiology and subspecialties like nephrology and endocrinology.
Anuradha Lala-Trindade, MD
Nearly 80% of US adults meet the criteria for stages A/B heart failure, and the traditional focus on late-stage treatment has not stopped the increase in the prevalence of or mortality from the disease, according to Anuradha 'Anu' Lala-Trindade, MD, a co-author of the statement and an associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York.
In addition to stressing earlier identification and intervention, the statement's authors encouraged broadening the lens beyond traditional risk factors such as high blood pressure, diabetes, and obesity to include sex-specific differences, genetic predisposition, environmental exposures, and lifestyle determinants to health.
High blood pressure, found in nearly half of all US adults, is the number one preventable risk factor for a number of cardiovascular diseases — including heart failure — as well as kidney disease, cognitive decline, and dementia, according to a new guideline from the American Heart Association and the American College of Cardiology. To control high blood pressure, patients are encouraged to make lifestyle changes and take medications as appropriate, and clinicians are encouraged to use the PREVENT risk calculator to estimate a patient's risk for cardiovascular disease and tailor treatment as warranted. The assessment considers measures of cardiovascular, kidney, and metabolic health.
Lala-Trindade noted that the statement on heart failure 'is a call to action for us to move towards integrated models of care where the whole person is prioritized rather than different organ systems and disease processes being siloed. It delivers a unified, practical framework that clinicians can apply today: integrating cardiovascular, metabolic, and kidney health to bend the heart failure curve. Its impact is far-reaching and if implemented widely, quality of life can be preserved and longevity extended for millions.'
Gulati has served on a data and safety monitoring board for Merck and serves on advisory boards for Medtronic, Bayer, and New Amsterdam. Lala-Trindade receives research support or honoraria from Astra Zeneca, Bayer, Cordio, Merck, Novo Nordisk, Zoll, WhiteSwell, Abiomed, and Sequana Medical.