Introduction and Context
Heart failure (HF) has emerged as one of the most significant public health challenges of the 21st century. Despite advancements in the treatment of acute coronary syndromes and hypertension, the prevalence of heart failure continues to rise, driven by an aging population and the increasing prevalence of obesity and type 2 diabetes mellitus (T2DM). Traditionally, cardiovascular risk assessment tools, such as the original SCORE and the more recent SCORE2/SCORE2-OP models, have focused primarily on predicting atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction and stroke. However, heart failure often follows a distinct pathophysiological pathway, frequently occurring in the absence of prior clinical ASCVD.
The development of the SCORE2-HF model represents a pivotal shift in preventive cardiology. By shifting the focus toward the early identification of individuals at high risk for incident heart failure, the European Society of Cardiology’s (ESC) Cardiovascular Risk Collaboration (CRC) Unit aims to provide clinicians with a tool that can guide more aggressive primary prevention strategies. This consensus-driven model is particularly timely as new therapies, such as SGLT2 inhibitors and GLP-1 receptor agonists, have demonstrated significant benefits in preventing heart failure hospitalization in high-risk patients.
