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Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association
Sadiya S. Khan, Khadijah K Breathett, Lynne T. Braun, Sheryl L. Chow, Deepak K. Gupta, Carolyn L. Lekavich, Donald M. Lloyd‐Jones, Chiadi E. Ndumele et al.. Circulation, 2025-04-16
Topic: Risk, prevention and care in population studies
The growing morbidity, mortality, and health care costs related to heart failure (HF) underscore the urgent need to prioritize its primary prevention. Whereas a risk-based approach for HF prevention remains in its infancy, several key opportunities exist to actualize this paradigm in clinical practice. First, the 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America HF guidelines provided recommendations, for the first time, on the clinical utility of multivariable risk equations to estimate risk of incident HF. Second, the American Heart Association recently developed the PREVENT (Predicting Risk of Cardiovascular Disease Events) equations, which not only enable prediction of incident HF separately, but also include HF in the prediction of total cardiovascular disease. Third, the predominant phenotype of HF risk has emerged as the cardiovascular-kidney-metabolic syndrome. Fourth, the emergence of novel therapies that prevent incident HF (eg, sodium-glucose cotransporter-2 inhibitors) and target multiple cardiovascular-kidney-metabolic axes demonstrate growing potential for risk-based interventions. Whereas the concept of risk-based prevention has been established for decades, it has only been operationalized for atherosclerotic cardiovascular disease prevention to date. Translating these opportunities into a conceptual framework of risk-based primary prevention of HF requires implementation of PREVENT-HF (Predicting Risk of Cardiovascular Disease Events-Heart Failure) equations, targeted use of cardiac biomarkers (eg, natriuretic peptides) and echocardiography for risk reclassification and earlier detection of pre-HF, and definition of therapy-specific risk thresholds that incorporate net benefit and cost-effectiveness. This scientific statement reviews the current evidence for accurate risk prediction, defines strategies for equitable prevention, and proposes potential strategies for the successful implementation of risk-based primary prevention of HF.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Khan, S. S., Breathett, K. K., Braun, L. T., Chow, S. L., Gupta, D. K., Lekavich, C. L., et al. (2025). Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association. Circulation. https://doi.org/10.1161/cir.0000000000001307
Vancouver
Khan SS, Breathett KK, Braun LT, Chow SL, Gupta DK, Lekavich CL, et al. Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2025. doi:10.1161/cir.0000000000001307. PMID: 40235437.
BibTeX
@article{khan2025-40235437,
author = {Khan, Sadiya S. and Breathett, Khadijah K and Braun, Lynne T. and Chow, Sheryl L. and Gupta, Deepak K. and Lekavich, Carolyn L. and Lloyd‐Jones, Donald M. and Ndumele, Chiadi E. and others},
title = {{Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association}},
journal = {Circulation},
year = {2025},
doi = {10.1161/cir.0000000000001307},
pmid = {40235437},
url = {https://doi.org/10.1161/cir.0000000000001307}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Third, the predominant phenotype of HF risk has emerged as the cardiovascular-kidney-metabolic syndrome.
- Fourth, the emergence of novel therapies that prevent incident HF (eg, sodium-glucose cotransporter-2 inhibitors) and target multiple cardiovascular-kidney-metabolic axes demonstrate growing potential for risk-based interventions.
- Whereas the concept of risk-based prevention has been established for decades, it has only been operationalized for atherosclerotic cardiovascular disease prevention to date.
- Translating these opportunities into a conceptual framework of risk-based primary prevention of HF requires implementation of PREVENT-HF (Predicting Risk of Cardiovascular Disease Events-Heart Failure) equations, targeted use of cardiac biomarkers (eg, natriuretic peptides) and echocardiography for risk reclassification and earlier detection of pre-HF, and definition of therapy-specific risk thresholds that incorporate net benefit and cost-effectiveness.
- This scientific statement reviews the current evidence for accurate risk prediction, defines strategies for equitable prevention, and proposes potential strategies for the successful implementation of risk-based primary prevention of HF.
Why it matters
This American Heart Association statement is about risk-based primary prevention of heart failure, including risk equations and therapies such as sodium-glucose cotransporter-2 inhibitors. It does not address Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 48 of the 97 points we could judge it on, which is 49 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Circulation) |
| Journal's citation record | 4 / 4 | Circulation: journal h-index 848 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 71 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 6 / 6 | Cited 45.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 71 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Larry A. Allen: h-index 81 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40235437) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 48 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 48 of the 97 points we could judge it on is 49 out of 100. |
| Total | 49 / 100 | — |
What each of these 20 components measures, and what this score is not →
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