Practical Prevention of Heart Failure Across Stages A and B: A Scientific Statement From the Japanese Heart Failure Society

Heart failure (HF) is a growing health problem in Japan, associated with substantial morbidity, mortality, recurrent hospitalization, impaired quality of life, and increasing health care costs. Early prevention before the onset of signs and symptoms has therefore become a major priority in cardiovascular medicine. This scientific statement from the Japanese Heart Failure Society provides practical prevention strategies for patients with HF stage A and stage B in Japan. Particular emphasis is placed on biomarker-guided screening using brain (B-type) natriuretic peptide and N-terminal pro-brain natriuretic peptide to facilitate earlier detection of stage B (pre-HF) and identification of patients at increased risk of progression to symptomatic HF. The statement summarizes evidence-based management of major cardiovascular-kidney-metabolic disorders associated with HF development, including hypertension, diabetes mellitus, chronic kidney disease, obesity, coronary artery disease, left ventricular dysfunction, valvular heart disease, and atrial fibrillation. It also addresses disease-specific approaches for optimizing blood pressure, glycemic control, renal protection, lipid management, and weight reduction. Preventive strategies include lifestyle modification, pharmacologic therapy, serial reassessment of natriuretic peptide levels, and appropriate use of cardiovascular imaging and timely specialist referral. Because many patients at risk for HF are managed outside specialized cardiovascular centers, practical pathways for collaboration between cardiologists and noncardiologist physicians are essential. The importance of timely referral, shared risk recognition, and multidisciplinary care is therefore emphasized. Implementation of clinically applicable prevention strategies may help reduce progression to symptomatic HF, facilitate earlier therapeutic intervention, and improve long-term cardiovascular outcomes.