Photo Credit: Pavel Muravev
The following is a summary of “Prioritizing the primary prevention of heart failure: Measuring, modifying and monitoring risk,” published in the January 2024 issue of Cardiology by Patel et al.
In response to the escalating prevalence of heart failure (HF) and the escalating associated morbidity, mortality, and healthcare costs, there is a growing imperative for primary prevention initiatives targeting individuals in at-risk HF (Stage A) and pre-HF (Stage B) stages. The primary objective is to curtail the progression to symptomatic HF (Stage C). The initial step involves identifying risks based on conventional factors such as cardiovascular health, assessed through the American Heart Association’s Life’s Essential 8 framework, adverse social determinants of health, inherited risk of cardiomyopathies, and factors that enhance risk, including viral diseases, exposure to cardiotoxic chemotherapy, and a history of adverse pregnancy outcomes. Subsequently, employing guideline-endorsed risk prediction tools like Pooled Cohort Equations to Prevent Heart Failure enables the quantification of absolute HF risk based on traditional factors. Core to prevention implementation is risk reduction through counseling on traditional factors. It may incorporate novel therapeutics like mineralocorticoid receptor agonists (e.g., fineronone), angiotensin-receptor/neprilysin inhibitors, and sodium-glucose co-transporter-2 inhibitors.
These interventions, however, face limitations in at-risk populations with adverse social determinants and individuals residing in rural areas. Therefore, strategies such as telemedicine are proposed to enhance access to preventive care. This comprehensive overview underscores existing gaps in the knowledge base for risk-based HF prevention. It emphasizes the need for future research employing artificial intelligence, genomics-enhanced strategies, and pragmatic trials. These endeavors aim to develop a guideline-directed medical therapy approach for risk reduction in individuals at Stage A and Stage B HF.
Source: sciencedirect.com/science/article/abs/pii/S003306202400001X
