HFSA and ASPC Release Statement on Shifting to Prevention in Heart Failure

On August 13, 2025, the Heart Failure Society of America (HFSA) and the American Society for Preventive Cardiology (ASPC) released a joint statement calling for a shift in how clinicians approach heart failure (HF) treatment, prioritizing prevention and risk identification rather than accepting it as an inevitable outcome.

Published in the Journal of Cardiac Failure (JCF) and the American Journal of Preventive Cardiology, the statement, titled “The Continuum of Prevention and Heart Failure in Cardiovascular Medicine,” presents a framework of potential preventive strategies across the various stages of heart failure, independent of ejection fraction. It also includes secondary prevention strategies in patients with established diseases and tertiary strategies in those with advanced therapies like heart transplants.1

“Prevention in heart failure isn’t a phase—it’s a mindset,” said lead author Anuradha Lala, MD, from the Mount Sinai Fuster Heart Hospital. “It applies not only before the onset of disease but continues after diagnosis and even following heart replacement therapy. At every stage, prevention ensures we care for the whole person, not just the failing heart.”1

In addition to detailing comorbidities and potential compounding risk factors, the statement calls for clinicians to take a more active role in identifying and preventing HF, highlighting critical drivers of the pathophysiologic cascade such as inflammation. The authors established a series of frameworks for identifying and measuring risk in patients, such as the cardio-kidney metabolic syndrome framework highlighting the interconnectedness of organ systems and the systemic nature of cardiovascular health.2

The publication also presents a series of preventive factors for lifelong HF control. Lifestyle changes such as quality sleep, balanced nutrition, regular exercise, weight management, and control of blood pressure, cholesterol, and glycemia, are highlighted throughout. The authors also noted these factors are critical in patients even without HF, across primary, secondary, and tertiary prevention strategies.2

Other risk factors, such as hypertension, diabetes, and obesity, as well as sex-specific, genetic, environmental, and social determinants of health, are emphasized throughout. Additionally, the release supports the implementation of AI-based models to improve early detection and risk stratification.2

“The implementation of AI carries the potential to improve the prevention and prediction of HF on multiple fronts, such as early and enhanced diagnosis, improved risk prediction, and remote monitoring and management,” Lala and colleagues wrote in the statement. “AI-based models for HF diagnosis, for example, include using the combination of ECG, echocardiogram, and electronic health data.”2

The statement also highlights wearable technology, such as smartwatches and patch monitors, which often engage individuals in their own healthcare by providing actionable insights directly without clinician involvement. Wearables designed specifically for HF may also improve outcomes for certain groups.2

Ultimately, the statement breaks down 4 primary components of heart failure prevention: early risk identification, holistic care, proven therapies, and system-wide change. All 4 are important steps on the road to a more proactive approach.1

The statement ends with a call for clinicians to collaborate between disciplines and to embrace technological and scientific innovation. A prevention-based mindset is critical to heart health, contradicting the historically fatalistic view of HF.2

“This is a wake-up call for the field,” said Martha Gulati, MD, MS, co-lead author. “We need to break down silos between preventive cardiology and heart failure care and create seamless strategies to identify and manage risk earlier. This needs to be a part of cardiovascular disease prevention.”1

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. August 13, 2025. Accessed August 13, 2025. https://www.hfsa.org/heart-failure-society-america-and-american-society-preventive-cardiology-joint-statement-calls-0

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. Journal of Cardiac Failure. 10.1016/j.cardfail.2025.06.013