A new joint guideline published today from the American College of Cardiology, the American Heart Association, and the Heart Failure Society of America, increases the focus on preventing heart failure (HF) in people who are showing early signs of “pre-heart failure,” and updates treatment strategies for people with symptomatic heart failure to include SGLT-2 inhibitor (SGLT2i) medicines. The guideline also offers recommendations for managing cardiac amyloidosis, cardio-oncology complications, comorbidities in the setting of heart failure, as well as consideration for implantable devices and advanced therapies for people with stage D heart failure.

Heart failure is a chronic condition that is usually manageable with medication and lifestyle changes. The most common causes of heart failure include narrowed heart arteries, heart attack, high blood pressure and valvular heart disease. Other causes can include, but are not limited to, familial or genetic cardiomyopathies, amyloidosis, metabolic disease, autoimmune disorders or exposure to cardiotoxic agents, such as chemotherapy or other medications. Primary prevention is important for those at risk of HF or pre-HF.

“One primary goal with the new guideline was to use recently published data to update our recommendations for the evaluation and management of heart failure,” said Paul A. Heidenreich, MD, MS, guideline writing committee chair. “One focus was prevention of heart failure through optimizing blood pressure control and adherence to a healthy lifestyle.”

The ACC/AHA stages of heart failure, from A – D, emphasize the development and progression of the disease, with advanced stages indicating more serious disease and reduced survival rate. The new guideline revised these stages to identify HF risk factors early, which is stage A, at risk for HF, and to provide treatment before structural changes or signs of decreased heart function occur, which is stage B, pre-HF.