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Am Fam Physician. 2023;108(3):315-320

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Given the evidence of delayed progression and decreased mortality, certain interventions should be started in patients at risk of heart failure who do not have symptoms.

• Guideline-directed medical therapy can reduce all-cause mortality by 73% compared with no treatment.

• If ejection fraction improves with guideline-directed medical therapy, stopping medications is associated with a high recurrence risk.

• In symptomatic heart failure, care from multidisciplinary teams is associated with improvements in mortality and function.

From the AFP Editors

Heart failure represents a broad spectrum of disease caused by impaired ventricular filling and contraction. While incidence has decreased over the past decade, mortality from heart failure has been increasing. The American Heart Association/American College of Cardiology (AHA/ACC) Joint Committee on Clinical Practice Guidelines, with members of the Heart Failure Society of America, published new guidelines on managing the condition, which include recommendations for patients at risk of heart failure and focus on therapy to prevent progression.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at

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