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(Circulation. 2008;117:2544-2565.)
© 2008 American Heart Association, Inc.

AHA Scientific Statement

Prevention of Heart Failure

A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group

Douglas D. Schocken, MD, FAHA, Chair; Emelia J. Benjamin, MD, MSc, FAHA; Gregg C. Fonarow, MD; Harlan M. Krumholz, MD, FAHA; Daniel Levy, MD, FAHA; George A. Mensah, MD, FAHA; Jagat Narula, MD, DM, PhD, FAHA; Eileen Stuart Shor, RN, PhD, NP, FAHA; James B. Young, MD, FAHA; Yuling Hong, MD, PhD, FAHA

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.

Key Words: AHA Scientific Statements • heart failure • prevention • left ventricular dysfunction • genetics • awareness

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