Heart failure experts share guidance on increasing prevention efforts

Cardiology has been shifting away from reactionary treatment strategies to a greater emphasis on prevention. With a shortage of heart failure specialists in the United States and hospitalization rates on the rise, reducing the number of advanced heart failure cases is a major target of such prevention efforts.

A joint scientific statement from the Heart Failure Society of America (HFSA) and the American Society for Preventive Cardiology (ASPC) about prevention in heart failure was released online in 2025 and then published in the Journal of Cardiac Failure (JCF) to kick off 2026.[1] The goal of the statement is to raise awareness that prevention efforts to stop the advance of heart failure symptoms should start with primary care and general cardiologists before the symptoms of these patients becomes critical. This is part of a wider effort across cardiology and medicine to try and reduce heart failure hospitalizations.

According to the Heart Failure Society, there are about 1.2 million primary heart failure hospitalizations each year and that number has continued to increase since 2014. Heart failure also accounts for about $32 billion in direct medical costs and $14 billion in indirect costs in the U.S.[2]  Heart failure is one of the leading causes of hospitalization in the U.S. and a major drain of Medicare resources.

"This is really calling for a movement from reactive to proactive care," lead author Anuradha Lala, MD, explained in an interview with Cardiovascular Business. She is a professor of medicine in cardiology and population health science with Mount Sinai Fuster Heart Hospital, program director for advanced heart failure and transplant fellowship and co-editor-in-chief at JCF. "If we want to change the heart failure epidemic, we need to stop waiting for heart failure to present itself. We also need a shift in culture to eliminate siloes of care and return to more wholistic care across the care continuum."

She said cardiologists are now so subspecialized that they may view a heart failure patient as a referral to a heart failure specialist. But there is an urgent need to start caring for these patients more broadly across the spectrum of care. Lala explained that heart failure does not happen in a vacuum or have one cause; it is often a culmination of health issues that could have been prevent earlier in that patient's journey through life and clinician visits. 

"Heart failure is the downstream expression of kidney metabolic syndrome, the same with elevated blood glucose levels and obesity. We say that all these roads lead to heart failure," Lala said.

The newly published statement emphasizes the links between cardiovascular disease prevention and heart failure, offering a roadmap to consider all aspects of preventive care. This includes primary prevention to reduce the burden of heart failure, secondary prevention to reduce its impact among those with an established diagnosis and tertiary prevention with the management of risk factors in patients who need advanced therapies like durable mechanical circulatory support and heart transplantation.

"While on the surface, preventive cardiology and heart failure may seem like disparate entities, the two specialties exist across a shared spectrum," the authors wrote. They pointed to the most recent American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) HF guidelines, which place special emphasis on heart failure prevention. The guidelines underscore the importance of identifying and treating those at risk, or who are considered pre-