# The Prevention of Heart Failure Risk: Assessment and Early Intervention along the Cardiovascular Continuum

## TL;DR

This paper discusses how heart failure can be prevented by identifying and managing risk factors early in the cardiovascular disease process.

## Contribution

The paper introduces a continuum-based approach to heart failure prevention, emphasizing early intervention and multidimensional risk assessment.

## Key findings

- Heart failure risk is driven by modifiable factors that can be addressed early in the disease trajectory.
- Combining modifiable risk factors with echocardiographic and lab markers improves risk stratification.
- A multidimensional approach is needed to identify at-risk individuals and prevent progression to symptomatic heart failure.

## Abstract

Heart failure (HF) is a complex clinical syndrome that develops as the final common manifestation of diverse cardiovascular disorders along a variety of different pathophysiological pathways. The trajectory towards HF is set decades earlier by a combination of non-modifiable risk factors and a substantial number of principally modifiable risk factors. Conceptualizing HF prevention as a continuum — from primordial prevention to tertiary prevention — highlights how consistently these factors determine and drive the risk to develop HF. Early at-risk and pre-HF stages therefore represent the most appropriate window for effective prevention, yet they are still underrated and under-recognized in clinical practice.

A broad array of modifiable risk factors, together with echocardiographic and laboratory markers, are involved in disease progression. Combining these domains may optimize risk stratification and enable more targeted prevention efforts.

The rapidly evolving heart failure pandemic, largely driven by the rising prevalence of conditions that are to a substantial extent attributable to modifiable risk factors, poses an enormous burden on health systems worldwide. In consequence, enhanced global awareness, comprehensive assessment and more effective control of modifiable risk factors are urgently needed to prevent HF. A multidimensional risk assessment approach could facilitate early identification and timely intervention to prevent progression to symptomatic HF.