Prevention of Heart Failure

Abstract

Abstract-The increase in heart failure (HF) rates throughout the developed and developing regions of the world poses enormous challenges for caregivers, researchers, and policymakers. Therefore, prevention of this global scourge deserves high priority. Identifying and preventing the well-recognized illnesses that lead to HF, including hypertension and coronary heart disease, should be paramount among the approaches to prevent HF. Aggressive implementation of evidence-based management of risk factors for coronary heart disease should be at the core of HF prevention strategies.Questions currently in need of attention include how to identify and treat patients with asymptomatic left ventricular systolic dysfunction (Stage B HF) and how to prevent its development. The relationship of chronic kidney disease to HF and control of chronic kidney disease in prevention of HF need further investigation. Currently, we have limited understanding of the pathophysiological basis of HF in patients with preserved left ventricular systolic function and management techniques to prevent it. New developments in the field of biomarker identification have opened possibilities for the early detection of individuals at risk for developing HF (Stage A HF). Patient groups meriting special interest include the elderly, women, and ethnic/racial minorities. Future research ought to focus on obtaining a much better knowledge of genetics and HF, especially both genetic risk factors for development of HF and genetic markers as tools to guide prevention. Lastly, a national awareness campaign should be created and implemented to increase public awareness of HF and the importance of its prevention. Heightened public awareness will provide a platform for advocacy to create national research programs and healthcare policies dedicated to the prevention of HF. (Circulation. 2008;117:2544-2565.) Key Words: AHA Scientific Statements Ⅲ heart failure Ⅲ prevention Ⅲ left ventricular dysfunction Ⅲ genetics Ⅲ awareness T he prevention of heart failure (HF) is an urgent public health need with national and global implications. According to the American Heart Association, an estimated 550 000 new cases occur each year. 1 More than 5 million Americans have HF. Among Medicare beneficiaries, HF is the leading cause of hospitalization. In 2007, the American Heart Association estimates that Ͼ$33 billion was spent on HF. 1 The syndrome of HF poses many challenges. Because of the complexity of its many causes and pathophysiological origins, HF may escape a unifying definition. From many The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the Ame...

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Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

“…Heart failure (HF) prevention is a top public health priority 1. Approximately 23 million people have HF worldwide,2 a number that is expected to rise because of the aging population and increasing prevalence of risk factors 3, 4.…”

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Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

“…The prevalence of HF with preserved ejection fraction (HFpEF) is high and increasing, making HFpEF a continuously growing public health problem 1, 2. Morbidity and mortality in HFpEF are quite similar to HF with reduced ejection fraction (HFrEF), but no effective pharmacological treatment has been identified so far3, 4, 5, 6 and a successful management of the disease remains elusive 2. Therefore, an intensified search for prevention and treatment strategies in HFpEF is of global interest.…”