Stage A

Individuals at high risk for Heart failure (HF)

Individuals in Stage A HF have predisposing factors that put them at high risk for developing the cardiomyocyte loss or dysfunction characteristic of HF. However, in many instances, steps can be taken to prevent or reduce the conditions that may progress to heart failure. The goal for these patients is to prevent cardiac structural changes including: hypertensive heart disease, cardiac remodeling, coronary heart disease (CHD) from developing.

Screening for Stage A patients

Patient assessment

Factors and conditions strongly associated with the development of HF (BCGuidelines, 2015)

  • Hypertension
  • Diabetes mellitus
  • Family histroy of cardiomyopathy or sudden death
  • Sleep apnea
  • Cardiovascular disease(e.g.,vavular heart disease, coronary heart disease, atrial fibrillation)
  • Smoking
  • Alcohol and substance abuse (current or past)
  • Age (60>)
  • Thyroid disease
  • COPD
  • Chronic kidney disease
  • Anemia
  • Metabolic Syndrome management

    Metabolic syndrome includes a cluster of risk factors that raises a person's risk for coronary heart disease, diabetes and stroke. Medications may be required if lifestyle changes including heart-healthy diet, weight control, managing stress, physical activity, and quitting smoking are not enough to reduce low density lipoprotein (LDL), hypertension and diabetes.

    The National Institutes of Health have identified five risk factors common to metabolic syndrome. The presence of three or more of these factors may indicate metabolic syndrome. The more risk factors a person has, the greater the chance of heart disease, diabetes and stroke.

    Five risk factors:

    • A large waistline also called abdominal obesity or having an apple shape. The excess fat in the stomach area creates the greatest risk factor for heart disease compared with excess fat in other parts of the body.
    • A high triglyceride level (or being treated for high triglycerides).
    • A low HDL cholesterol level (or on medicine to treat low HDL cholesterol).
    • High blood pressure (or on medicine to treat high blood pressure).
    • High fasting blood sugar (or on medicine to treat high blood sugar) (NHLBI, 2016).


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