HFSA/ASPC Heart Failure Prevention: Prevention Across the Full Heart Failure Timeline

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 third 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 how to implement prevention across every stage of heart failure progression.

Gulati explains that patients with pre–heart failure, often managed by general cardiologists, remain at significant risk of progressing to symptomatic heart failure, especially if they already have cardiovascular disease or early signs of damage. She highlights the importance of aggressive treatment and prevention strategies, guided by the “Life’s Essential 8” framework, to address modifiable risk factors.

Advances such as biomarkers for early detection and new therapies for conditions like obesity have expanded the toolbox for clinicians, offering opportunities to intervene earlier and prevent patients from ever receiving a heart failure diagnosis.

Lala expands on this by stressing the need for a paradigm shift in how cardiologists and other physicians approach patient care—moving away from siloed specialties to a more integrated view of cardio-kidney-metabolic health. She emphasizes that dysfunction in one system must be recognized as part of a larger problem tied to cardiovascular health. This holistic approach reframes the physician’s role, encouraging responsibility for the patient’s overall health trajectory rather than just isolated conditions.

For patients already in stage C or D heart failure, Lala notes that prevention is still highly relevant. While clinicians must manage active symptoms, they should also focus on preventing progression to more advanced disease stages by using guideline-directed therapy and aggressively treating comorbidities. Even after interventions like heart transplant or mechanical support, the same principles of prevention apply.

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