Lancet Review Frames Heart Failure Prevention Within Cardiovascular-Kidney-Metabolic Health
This position paper argues that heart failure prevention should be repositioned within an integrated cardiovascular, kidney, and metabolic (CKM) framework, citing converging epidemiological evidence and trial data from SGLT2 inhibitors and GLP-1 receptor agonists. The authors propose an actionable model spanning patient, clinician, health system, and policy levels to address the interconnected pathophysiology driving incident heart failure.
The original study
Cardiovascular, kidney, and metabolic health: an actionable vision for heart failure prevention.
- Authors
- Ostrominski JW, Cheng AYY, Nelson AJ, Neuen BL, Sattar N, Tuttle KR, et al.
- Journal
- Lancet (London, England)
- Type
- Journal Article, Review
- PMID
- 40889511
Original abstract
The substantial and growing prevalence of heart failure, which remains the leading cause of preventable hospitalisation worldwide, has brought heart failure prevention into sharp focus. Although this condition has historically been characterised by impaired cardiac function, mounting evidence has underscored its complex and multisystem pathobiology. Epidemiological studies have indicated that other forms of cardiovascular disease, along with kidney and metabolic dysfunction, frequently and increasingly contribute to heart failure onset. Clinical trials have additionally demonstrated the power of several new pharmacotherapies to simultaneously modify cardiovascular, kidney, and metabolic (CKM) health. This convergence of epidemiology and therapy highlights deeply interconnected mechanisms of disease, identifying CKM diseases-and their pathophysiological and sociostructural antecedents-as important but often under-recognised targets for heart failure prevention. Herein, we illustrate that positioning heart failure prevention within the broader context of CKM health provides an actionable framework for patients, health-care professionals, health systems, communities, and policy makers.