Primary prevention

Consider interventions aimed at modifying risk factors in order to delay or prevent the onset of acute heart failure, including:[1]

  • Coronary artery disease: manage with aspirin, beta-blockers, statins, and ACE inhibitors, as needed

    • Optimising treatment of hypertension, smoking cessation, and lipid control provides substantial benefit in patients with coronary artery disease[1] 

    • Optimal control of hypertension may require more than one antihypertensive medication.[17] Different antihypertensive drugs (diuretics, ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers) have been shown to be effective, especially in older people, both with and without a history of myocardial infarction[1]

  • Diabetes mellitus: in addition to metabolic control, ensure aggressive control of lipids and blood pressure[18][19]

  • Alcohol consumption and excessive salt and fluid intake: discourage in patients with known left ventricular dysfunction[20]

  • Drugs that can cause or potentiate heart failure: avoid, if safe and possible to do so.[21]

Secondary prevention

All patients with heart failure are recommended to have pneumococcal vaccination and annual influenza vaccine.

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