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Prevention of heart failure: a scientific statement of the Heart Failure Association, the European Association of Preventive Cardiology, and the Association of Cardiovascular Nursing & Allied Professions of the ESC, and the ESC Council on Hypertension
Massimo PiepoliGiuseppe RosanoAna AbreuMarianna AdamoAndrea AttanasioOvidiu ChioncelAlain Cohen-SolalGerasimos FilippatosEva GerdtsAndreas GevaertMartin HallePardeep JhundDonata KurpasBrenda MouraGianfranco ParatiMark C. PetrieEduard ShantsilaMaggie SimpsonIsabella SudanoMaryia TokmakovaDaniela TomasoniIzabella UchmanowiczMaurizio VolterraniMarco Metra
Why the study?
Significant evidence has emerged since 2022 regarding heart failure prevention, particularly concerning metabolic disorders, diabetes, and kidney diseases.
Key Points
- This statement aims to emphasize the importance of a comprehensive approach to preventing heart failure by addressing various risk factors and comorbidities.
- Position paper by Heart Failure Association, European Association of Preventive Cardiology, and related entities, published in 2022
- Reviewed evidence on prevention strategies, particularly focusing on metabolic disorders and kidney diseases
- Identification of key risk factors for heart failure including hypertension, chronic kidney disease, and diabetes mellitus.
- Emphasis on a tailored approach considering female-specific risks and adverse effects of treatments like chemotherapy.
- Highlighting the impact of socio-economic determinants and lifestyle factors on heart failure prevention.
Structured PICO
P
Population
Individuals at risk for heart failure, particularly those with metabolic disorders, diabetes, kidney diseases, arterial hypertension, obesity, and other risk factors.
E
Exposure
Multidisciplinary preventive measures addressing comorbidities and risk factors (e.g., hypertension, chronic kidney disease, diabetes mellitus, sedentary lifestyle, obesity, dyslipidemia).
O
Outcome
Prevention of heart failure
This scientific statement provides an updated perspective on the prevention of heart failure, emphasizing a holistic and tailored approach to managing metabolic, renal, and other multifaceted risk factors.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Heart failure is one of the most common complications of cardiovascular diseases and remains a major cause of hospitalization and premature mortality. Population ageing and the increasing prevalence of obesity, diabetes, and hypertension mean that the number of patients continues to grow. Therefore, preventive measures are now of key importance both for patients' health and for the sustainability of healthcare systems.”
“The greatest impact comes from measures aimed at modifying risk factors: regular physical activity, a healthy diet, maintaining a healthy body weight, and avoiding tobacco use. Growing evidence also highlights the importance of individualized prevention strategies and the early implementation of effective therapies in high-risk individuals.”
“From the perspective of integrated care, heart failure prevention should not begin only in a cardiology clinic but much earlier-in primary care, through health education, within local communities, and through everyday decisions that support heart health throughout life. This approach is also reflected in the 'Keep Your Pressure Under Control' campaign conducted by Wroclaw Medical University. Its goal is to raise awareness of a problem that may remain unnoticed for years.”
Implication
Multidisciplinary HF prevention addressing comorbidities may lower burden; leaves open optimal components amid shifting non-ischemic phenotypes.
Abstract
Heart failure (HF) remains a major cause of morbidity, mortality and costs for the healthcare systems worldwide, despite advances in diagnostic and therapeutic strategies. The enhancement of preventive measures is now a priority, but effective prevention requires a multidisciplinary strategy addressing a broad spectrum of comorbidities and risk factors. It must also consider the changes in the prevailing phenotype of the patients with HF with a lower impact of coronary artery disease and the increasing role of renal and metabolic conditions leading mostly to HF with preserved ejection fraction. Prevention of HF must take into consideration arterial hypertension, chronic kidney disease, diabetes mellitus, sedentary lifestyle, obesity, dyslipidemia, female-specific risk factors, as well as adverse effects of chemotherapy and radiotherapy. Other key factors include infections and the protective role of vaccination, and environmental and socio-economic determinants of health. In 2022, a position paper of the Heart Failure Association and the European Association of Preventive Cardiology of the ESC was published as a complete overview on this topic and as a compendium to the 2021 ESC Guidelines on HF. However, since then, significant evidence has emerged regarding the potential to prevent HF, particularly in the context of metabolic disorders, diabetes and kidney diseases. This scientific statement aims to provide an updated perspective, highlighting the importance of a holistic and tailored approach to managing the multifaceted contributors to this syndrome.
Discussion
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Cite This Study
Piepoli et al. (2026) conducted a review in Heart failure. Preventive measures was evaluated. This updated scientific statement highlights the importance of a holistic and tailored approach to preventing heart failure by managing metabolic disorders, diabetes, and kidney diseases.