The continuum of prevention and heart failure in cardiovascular medicine: A joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology

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  Central Figure: Depictions for treatment included herein are not exhaustive. Blood pressure and lipid management for example are included under Life's Essential 8 as outlined, however detailed discussion of their management are not included here however. Please refer Table 1. The prevention of heart failure (HF) should occur at all stages, including identification of persons at risk of HF to those living with HF, to those who have gone on to receive heart replacement therapies. Many aspects of HF prevention are common irrespective of HF Stage. ***This central figure is not exhaustive (i.e., does not include discussion of traditional hypertension and lipid management), but these are applicable per current guidelines (see below) and are further outlined in Table 1. Heidenreich, P. A. et al. 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure: Executive Summary. Journal of Cardiac Failure, Volume 28, Issue 5, 810 – 830. ACEi= angiotensin-converting enzyme inhibitors; ARB=angiotensin II receptor blocker; ARNi=angiotensin receptor neprilysin inhibitor; BP=blood pressure; CAV=coronary allograft vasculopathy; CKD= chronic kidney disease; DM= diabetes GLP-1RA= glucagon-like…

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  Fig. 1. Staging and classification of heart failure. ACC= American College of Cardiology; AHA= American Heart Association; HF=heart failure; NYHA = New York Heart Association; HFrEF = heart failure with reduced ejection fraction; HFpEF = heart failure with preserved ejection fraction; HFmrEF = heart failure with mid-range ejection fraction; HFimpEF = heart failure with improved ejection fraction.

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  Fig. 2. Traditional and non-traditional risk factors for heart failure. Summary of the traditional and nontraditional risk factors detailed in this statement that predispose to the development and progression of heart failure. CKD = chronic kidney disease.

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  Fig. 3. Pathologic underpinnings linking obesity to the development and progression of heart failure. Overview of the multiple pathophysiologic pathways by which obesity contributes to the development of heart failure, including upregulation of inflammatory pathways, increased visceral adipose tissue resulting in cardiac remodeling, and perturbations in the leptin-aldosterone-neprilysin framework.

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  Fig. 4. Risk assessment in heart failure. Summary of available risk assessment and stratification tools and an overview of the cardiovascular-kidney-metabolic framework and staging classification. ASCVD = atherosclerotic cardiovascular disease; PCP-HF = PC equations to Prevent HF; PREVENT = Predicting Risce of Cardiovascular Disease EVENTs score; NT-proBNP = N-terminal Pro-Brain Natriuretic Peptide; BNP = Brain Natriuretic Peptide; hs-cTnT = high sensitivity cardiac troponin T; UACR = urine albumin to creatinine ratio; CRP = c-reactive protein; T2DM = Type 2 Diabetes Mellitus; CKM = cardiovascular-kidney-metabolic; CVD = cardiovascular disease; CHD = coronary heart disease; CKD = chronic kidney disease; A fib = atrial fibrillation; PVD = peripheral vascular disease; HF = heart failure; HTN = hypertension.

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  Fig. 5. Multidisciplinary partnerships and holistic care required in the prevention of heart failure.