More than 6 million Americans are currently affected by heart failure, with prevalence expected to nearly double by 2050. Even with pharmacological advances, nearly 1 in 5 patients with heart failure die within a year.
Now, a roadmap from major organizations reframes heart failure as a preventable condition rather than an inevitable outcome, calling for the early management of risk factors like blood pressure, weight, and glucose levels decades before symptoms appear. This shift in approach was recently formalized in a joint statement by the Heart Failure Society of America (HFSA) and the American Society for Preventive Cardiology.
Jointly 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, offers a shared framework where, for the first time, prevention is placed at the forefront of care. By breaking down silos between medical disciplines, the initiative promotes a continuous, multidisciplinary approach to care that applies to the whole person at every stage of the disease.
“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.”
To celebrate Heart Failure Awareness Week 2026, which runs from February 8-14, PatientCareOnline spoke with Muthiah Vaduganathan, MD, MPH, cardiologist and clinical trialist at Brigham and Women’s Hospital at Harvard Medical School, to discuss the concept of heart failure as a preventable disease and primary care’s crucial role in disease management.
Primary Care’s Role in Heart Failure Prevention, Management Strategies
Patient Care: Why is it important to reframe heart failure as a preventative disease that begins with primary care?
Muthiah Vaduganathan, MD, MPH: Heart failure is unfortunately diagnosed too late in many cases, and often in the hospital. At that point, prognosis is already limited, and disease progression occurs fairly rapidly, even with available therapies. Moving upstream is not only important in terms of broader detection of heart failure, but also in diagnosing it at earlier stages of development, so we can implement therapies properly and potentially avoid that first event – hospitalization.
Patient Care: What are some of the early, subtle signs that a primary care clinician should consider as potentially indicative of heart failure?
Muthiah Vaduganathan, MD, MPH: Often, some of the earliest signs include exertional dyspnea, as well as more subtle aspects like fatigue that may be dismissed as simply aging. While heart failure incidence and prevalence do increase with age, healthy aging doesn’t necessarily require the presence of heart failure. These symptoms should prompt primary care clinicians to test for potential subclinical risk, for instance, with natriuretic peptides, which are simple biomarkers that can tell us a lot about cardiac stress, even in early stages. If those are abnormal, further testing with imaging modalities like echocardiography can help understand if there are cardiac structural or functional abnormalities.
Patient Care: After referring a patient to cardiology, where do you see the ideal interplay between a cardiologist and their primary care clinician?
Muthiah Vaduganathan, MD, MPH: Heart failure is a long-term condition with an undulating disease course, often punctuated by clinical events like hospitalizations. It requires medication titration, close laboratory and clinical follow-ups. The initial referral doesn’t mean relinquishing care of the patient. This is a collaboration in management, and a continued alliance between primary care clinicians and cardiologists can improve the patient experience by improving each touchpoint in care and keeping everything closely linked.
Patient Care: What have been the most common misconceptions you’ve heard about the role of primary care within heart failure?
Muthiah Vaduganathan, MD, MPH: I think a misconception is that primary care’s role ends when a patient is referred to a cardiologist. However, primary care clinicians are often the first point of contact where patients report subtle symptoms and may present with early signs. They have an essential role in diagnosing and detecting heart failure in its earliest phases, because this is the time point in which we can actually make a difference in the patient journey.
Patient Care: If you could wave a magic cardiology wand and have one sweeping change within primary care and their approach to these patients, what would that be?
Muthiah Vaduganathan, MD, MPH: Primary care clinicians have a lot on their plate, screening for numerous chronic conditions and testing for various laboratory abnormalities. But heart failure is also an important aspect that should be included in that scope of care. We often think about screening for cancer, lipid abnormalities, or diabetes, but heart failure today can be screened for. There is readily available and inexpensive laboratory testing that provides interpretable information about an individual’s risk of developing heart failure or even subclinical evidence of cardiac stress. So, primary care clinicians should consider heart failure as part of their daily clinical practice, alongside screening for these other chronic conditions.
Patient Care: If you were to recommend a short list of these screenings, what would they be?
Muthiah Vaduganathan, MD, MPH: We now have comprehensive cardiovascular risk prediction algorithms, such as the American Heart Association prevent equations, that give you global assessments. It’s difficult to focus on a particular aspect of cardiovascular risk when screening for cardiovascular disease or forecasting risk. Scores like Prevent integrate numerous markers and clinical abnormalities to give you an integrative risk assessment. Some of those markers, as you mentioned, include BNP and UACR, which provide comprehensive assessments of both cardiac stress and endothelial function.
Patient Care: Any message to primary care or even cardiologists out there on heart failure as a preventable disease?
Muthiah Vaduganathan, MD, MPH: Heart failure is no longer just a disease of aging, or considered the end-stage form of heart disease with an inevitable course. Today, heart failure is a condition that can be detected early, predicted, and even prevented with available therapies. And if heart failure does occur, whether with reduced or preserved ejection fraction, we now have tools that can effectively manage the condition and prevent long-term disease complications.
Editor’s Note: The above transcript has been lightly edited for grammar, and clarity.
Poko L. Heart Failure Society of America and American Society for Preventive Cardiology Joint Statement Calls for a Shift in Heart Failure Prevention and Care | HFSA. Hfsa.org. Published 2025. Accessed February 10, 2026. https://hfsa.org/heart-failure-society-america-and-american-society-preventive-cardiology-joint-statement-calls-0
