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The enhancement of preventive measures is now a priority, but effective prevention requires a multidisciplinary strategy addressing a broad spectrum of comorbidities and risk factors. It must also consider the changes in the prevailing phenotype of the patients with HF with a lower impact of coronary artery disease and the increasing role of renal and metabolic conditions leading mostly to HF with preserved ejection fraction. Prevention of HF must take into consideration arterial hypertension, chronic kidney disease, diabetes mellitus, sedentary lifestyle, obesity, dyslipidemia, female-specific risk factors, as well as adverse effects of chemotherapy and radiotherapy. Other key factors include infections and the protective role of vaccination, and environmental and socio-economic determinants of health. In 2022, a position paper of the Heart Failure Association and the European Association of Preventive Cardiology of the ESC was published as a complete overview on this topic and as a compendium to the 2021 ESC Guidelines on HF. However, since then, significant evidence has emerged regarding the potential to prevent HF, particularly in the context of metabolic disorders, diabetes and kidney diseases. This scientific statement aims to provide an updated perspective, highlighting the importance of a holistic and tailored approach to managing the multifaceted contributors to this syndrome.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehag362","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:09:20Z","timestamp":1777637360000},"page":"4375-4395","source":"Crossref","is-referenced-by-count":2,"title":["Prevention of heart failure"],"prefix":"10.1093","volume":"47","author":[{"given":"Massimo","family":"Piepoli","sequence":"first","affiliation":[{"name":"Department of Biomedical Science for Health, University of Milan , Milan ,","place":["Italy"]},{"name":"Cardiology University Department, IRCCS Policlinico San Donato , Piazza Edmondo Malan, Milan 20097 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-2263","authenticated-orcid":false,"given":"Giuseppe","family":"Rosano","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele , Rome ,","place":["Italy"]},{"name":"Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0786-7830","authenticated-orcid":false,"given":"Ana","family":"Abreu","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiac Rehabilitation Centre, Hospital Universit\u00e1rio Santa Maria (ULSSM), Centro Acad\u00e9mico Medicina de Lisboa (CAML) , Lisbon ,","place":["Portugal"]},{"name":"Faculty of Medicine from University of Lisbon (FMUL), Instituto de Sa\u00fade Ambiental (ISAMB)\/TERRA, Instituto Medicina Preventiva e Sa\u00fade P\u00fablica (IMPSP), Centro Cardiovascular da Universidade de Lisboa (CCUL) , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-1815","authenticated-orcid":false,"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Attanasio","sequence":"additional","affiliation":[{"name":"Cardiology University Department, IRCCS Policlinico San Donato , Piazza Edmondo Malan, Milan 20097 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-3628","authenticated-orcid":false,"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. 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