Prevention of heart failure.

Heart failure carries a sizeable health burden. Efforts to prevent this condition are not generally well studied. Most of the interventions that have demonstrated benefit address cardiac risk factors such as hypertension and hyperlipidemia. The results of the HOPE study have recently expanded the indications for angiotensin converting enzyme inhibitors in the prevention of heart failure. Once heart failure occurs, a variety of interventions can prevent recurrent episodes of congestion. Biventricular pacing, left ventricular assist devices, and disease-specific management clinics join more standard medical therapies such as angiotensin converting enzyme inhibitors, beta-blockers, diuretics, digoxin, and spironolactone in improving outcomes for patients with this disorder.