Optimal medical treatment of cardiovascular risk factors: can we prevent the development of heart failure?

Coronary heart disease is the most common cause of heart failure. Its prevalence has increased mainly owing to the improved survival of patients after acute myocardial infarction. In patients with heart failure, the presence of coronary heart disease has been shown to be independently associated with worsened long-term outcomes, including hospitalizations and poor mortality. Coronary heart disease frequently coexists with several major risk factors for the onset and progression of heart failure, such as hypertension, diabetes, obesity and metabolic syndrome, among others. Medical efforts to reduce the incidence of heart failure burden in patients with coronary heart disease and other types of cardiomyopathies must be directed at the prevention of heart failure and coronary risk factors themselves, and not just at the improvement of the management of established disease. This article will address the impact of known risk factors in the development of coronary heart disease and heart failure.