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

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 heart failure 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.1

In the fifth episode of a 7-part HCPLive Special Report, 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.

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.

Our Panelists:

• James Januzzi, MD, 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.
• Martha Gulati, MD, MS, 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.
• Anu Lala, MD, 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.

References:

1. 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. PRNewswire. 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

2. 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. doi:10.1016/j.ajpc.2025.101069