Growing heart failure epidemic calls for prioritizing primary prevention

A rapidly growing heart failure epidemic calls for prioritizing primary prevention, according to a new scientific statement from the American Heart Association published in Circulation in April. The statement reviews the current evidence for predicting heart failure risk and offers strategies for heart failure prevention, according to a recent MedCentral article.

An estimated 6.7 million U.S. adults have heart failure, and that number is projected to exceed 11 million by 2050, according to the statement. Heart failure is now the leading cause of hospitalization for adults 65 years and older, and the incidence is increasing in younger adults. Mortality rates have increased during the past decade as well, with a 15% increase in mortality from 2018 to 2021. 

However, the AHA statement points out that once pre-heart failure has been identified or when elevated risk is established, the condition can be prevented or delayed with therapies.

The statement recommends using the PREVENT (Predicting Risk of cardiovascular disease EVENT) risk calculator.

The new statement also identifies non-traditional risk factors that can contribute to the development of heart failure — but are easy to overlook, including chronic inflammatory disease, exposure to cardiotoxins, adverse pregnancy outcomes, metabolic dysfunction-associated steatotic liver disease (MASLD) and inherited risk.

It is also important to be aware of comorbidities, some of which are frequently overlooked by clinicians, said Richard Becker, MD, professor in the division of cardiovascular health and disease at the University of Cincinnati College of Medicine and director and physician-in-chief of the UC Heart, Lung and Vascular Institute.

“Chronic kidney disease (CKD) is a significant comorbidity that is often under addressed despite its strong association with heart failure. Even a mildly reduced GFR can portend an increased risk,” Becker said, noting, “the statement emphasizes the importance of recognizing CKD as a key target for heart failure prevention, especially with the advent of kidney-protective therapies.”

He added that hypertension can begin during youth and is often overlooked.

Read what Becker says about lifestyle changes to address comorbidities and underlying risk factors.

Featured image at top: iStock/Rasi Bhadramani.