Anuradha Lala-Trindade, MD

Making Heart Failure Prevention Accessible

A joint statement by the American Society for Preventive Cardiology (ASPC) and the Heart Failure Society of America (HFSA), published on August 13, 2025, shifts the focus of 

 from recovery to prevention for the first time. “The Continuum of Prevention and Heart Failure in Cardiovascular Medicine” provides clinicians with a framework of strategies to apply across all stages of heart failure, irrespective of ejection fraction.

Instead of viewing the condition as an inevitable outcome, this statement recontextualizes heart failure as a preventable condition. It encourages clinicians to identify and manage risk factors earlier through methods such as glucose management, genetic risk screening, lifestyle interventions, weight loss, and blood pressure control.

In the seventh and final episode of a 7-part 

, moderator James Januzzi, MD, is joined by Martha Gulati, MD, MS, and Anu Lala, MD, to discuss the urgent need to bridge the gap between prevention and heart failure care.

Januzzi highlights ongoing inequities in cardiovascular care, noting that heart failure and related risk factors disproportionately affect marginalized populations with limited access to quality healthcare. He stresses that addressing these disparities will require significant health system and policy changes, especially as demographic shifts in the U.S. are projected to increase the burden of disease in these communities.

Lala adds 5 key takeaways for primary care: heart failure is preventable; prevention applies across the lifespan; screening should start early using tools like natriuretic peptides and UACR; patient care must take a whole-person, whole-team approach; and clinicians should proactively prescribe effective therapies such as SGLT2 inhibitors, ARNIs, and aggressive blood pressure control.

, is the Hutter Family Professor of Medicine at Harvard and the Director of Heart Failure and Biomarker Trials at the Balm Institute for Clinical Research. Januzzi serves as the moderator for this conversation.

, is the associate director of the Barbra Streisand Women Heart Center and the director of CVD Prevention at the Smidt Heart Institute at Cedars Sinai Medical Center. She was also the president of the ASPC from 2022-2024.

, is an associate professor of medicine at the Zena & Michael A Wiener Cardiovascular Institute, and a member of the Department of Population Health Science and Statistics at Icahn School of Mount Sinai and Mount Sinai Hospital.

Editors’ Note: Januzzi reports disclosures with Abbott Laboratories, AbbVie, Inc., Eli Lilly, AstraZeneca Pharmaceuticals, Jana Care, Siemens, and others. Gulati reports disclosures with the American Society of Preventive Cardiology, Eli Lilly, Merck & Co., Boehringer Ingelheim Pharmaceuticals, Medtronic, Zoll, and others. Lala reports disclosures with Abiomed, AstraZeneca, Merck & Co., Novo Nordisk, Sequana, Bayer, and others.

Heart Failure Society of America. Heart Failure Society of America and American Society for Preventive Cardiology Joint Statement Calls for a Shift in Heart Failure Prevention and Care. 

 August 13, 2025. Accessed September 9, 2025. 

https://www.prnewswire.com/news-releases/heart-failure-society-of-america-and-american-society-for-preventive-cardiology-joint-statement-calls-for-a-shift-in-heart-failure-prevention-and-care-302529062.html

Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in Cardiovascular Medicine: A joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. American Journal of Preventive Cardiology. Published online August 13, 2025:101069. 

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In the final segment of this 7-part HCPLive Special Report, experts discuss the recently released ASPC/HFSA heart failure prevention statement.

HFSA/ASPC Heart Failure Prevention: Making Heart Failure Prevention Accessible

Heart Failure in Women

Instead of viewing the condition as an inevitable outcome, this statement recontextualizes heart failure as a preventable condition. It encourages clinicians to identify and manage risk factors earlier through methods such as glucose management, genetic risk screening, lifestyle interventions, weight loss, and blood pressure control.1

 moderator James Januzzi, MD, is joined by Martha Gulati, MD, MS, and Anu Lala, MD, to discuss the urgent need to bridge the gap between prevention and heart failure care.

Lala outlines three key priorities for improving prevention in women at risk for heart failure: early identification, closing implementation gaps, and driving policy and payment reform. She stresses that many existing risk tools are based on male populations, which leads to underrecognition of women’s risks. Since women more commonly present with heart failure with preserved ejection fraction (HFpEF) rather than systolic dysfunction, prevention strategies must reflect these differences. She also emphasizes that women often receive less therapy and attention than men, making equitable implementation critical to improving outcomes.

Gulati expands on this, highlighting the importance of sex-specific risk factors in refining risk assessment. Traditional risk calculators, heavily weighted by age, often underestimate the risks faced by young women, such as those experiencing adverse pregnancy outcomes like preeclampsia, gestational diabetes, or hypertension during pregnancy. 

These conditions elevate risks for both cardiovascular disease and heart failure within a decade, not just later in life. She also draws attention to peripartum cardiomyopathy and Takotsubo syndrome—forms of heart failure disproportionately affecting women—that are often underdiagnosed and lack effective preventive strategies.

Both experts agree that greater inclusion of women in clinical trials is essential for understanding how therapies apply across sexes. Gulati notes that intentional enrollment efforts have already begun to improve representation in heart failure research, shifting from historically poor female participation toward more balanced studies. This progress, she argues, demonstrates that with deliberate action, clinical trials can better capture sex differences, ultimately informing more effective and equitable care for women at risk of or living with heart failure.

In part 6 of this 7-part HCPLive Special Report, experts discuss the recently released ASPC/HFSA heart failure prevention statement.

HFSA/ASPC Heart Failure Prevention: Heart Failure in Women

Addressing Unmet Needs in Heart Failure

Gulati identifies several pressing unmet needs in heart failure prevention, beginning with chronic kidney disease. She stresses that reliance on GFR alone is inadequate, as kidney damage is already present when GFR changes, and advocates for broader use of the urine albumin-to-creatinine ratio (UACR) as an essential biomarker.

She also highlights major gaps in basic risk factor management, particularly hypertension control, noting that only a small fraction of patients are adequately treated despite hypertension being highly modifiable. Gulati emphasizes the need for structured approaches—such as checklists, electronic health record prompts, and system-level interventions—to ensure guideline-directed therapy is consistently applied.

Januzzi reinforces the value of systematic programs, describing how at Mass General, nurse practitioners, physician assistants, and pharmacists are central to a guideline-directed medical therapy program that has dramatically improved outcomes for heart failure patients. He argues that similar team-based models should be extended to earlier stages of disease, not just advanced cases. This approach, he says, helps reverse dysfunction, improve quality of life, and ultimately reduce costs.

In part 5 of this 7-part HCPLive Special Report, experts discuss the recently released ASPC/HFSA heart failure prevention statement.

HFSA/ASPC Heart Failure Prevention: Addressing Unmet Needs in Heart Failure

The Need for Interdisciplinary Collaboration in Heart Failure

, moderator James Januzzi, MD, is joined by Martha Gulati, MD, MS, and Anu Lala, MD, to discuss the interdisciplinary nature of heart failure treatment.

Januzzi reflects on how managing heart failure requires addressing the full spectrum of cardiovascular disease and related conditions such as obesity, chronic kidney disease, liver disease, hypertension, and sleep apnea. He emphasizes that the traditional fragmented approach to care is no longer sustainable, and instead, a coordinated, multidisciplinary model is essential. This shift means cardiologists and other specialists can no longer “hand off” issues solely to primary care but must actively engage in a team-based strategy.

Lala notes that while it’s easy to discuss prevention philosophically, the challenge lies in translating it into real-world outcomes. Effective prevention requires collaboration with nutritionists, exercise physiologists, endocrinologists, nephrologists, and primary care providers. She stresses the need for cross-specialty communication, particularly as cardiologists increasingly prescribe therapies once left to other disciplines. Lala also highlights systemic barriers, such as reimbursement models, that must evolve to support truly integrated care.

Gulati adds a practical perspective, pointing out that cardiologists often end up making initial diagnoses of diabetes or kidney disease because specialists are in short supply and referral wait times are long. She argues that while cardiologists don’t need to be experts in endocrinology or nephrology, they should be equipped to initiate treatment.

In part 4 of this 7-part HCPLive Special Report, experts discuss the recently released ASPC/HFSA heart failure prevention statement.

Anuradha Lala-Trindade, MD

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