Heart failure now affects more than 56 million people worldwide, and the number keeps climbing. In response, a coalition of global health experts has issued a sweeping update to how the condition is defined, classified, and managed. The change is one of the most significant shifts in cardiovascular medicine in years.
According to Healthline, the update was published in June in the American Heart Association journal. It is called the Second Universal Definition of Heart Failure and builds on an earlier document first issued in April 2021. The new guidelines were developed with input from the American Heart Association and the American College of Cardiology, among other organizations.
The rise in heart failure cases is being driven partly by aging populations and by the growing rates of obesity, type 2 diabetes, and high blood pressure. All of these conditions contribute to cardiovascular disease. Experts say the old definition was inconsistent across countries and institutions, which slowed down research and limited treatment options.
"Heart failure remains a major challenge that continues to grow globally, and inconsistencies in how it is defined have limited progress in research and treatment," said Mary Norine Walsh, MD, co-chair of the consensus document for the AHA and ACC, and medical director of the heart failure program at Ascension St. Vincent Heart Center in Indianapolis.
Walsh added that the updated definition gives clinicians a better tool. "This updated definition provides a clearer, more consistent framework to help clinicians identify risk earlier and guide more personalized treatment approaches that can help improve patient outcomes worldwide," she said.
One of the key changes in the new guidelines is a standard classification system for the causes of heart failure. Before this update, different hospitals and researchers often used different frameworks, which made it harder to compare data across studies and patient registries. The new system is meant to fix that problem.
Gregg Fonarow, MD, interim chief of the Division of Cardiology at the University of California Los Angeles and director of the Ahmanson-UCLA Cardiomyopathy Center, told Healthline why consistency matters. "The updated universal definition of heart failure matters because it finally brings global consistency to how we diagnose and describe heart failure," he said.
The document authors say the classification framework will help with standardized reporting of data from trials and registries. It will also allow clinicians to better identify underlying conditions and guide care that goes beyond the current standard treatment for heart failure.
The new document will serve as the foundation for the upcoming AHA/ACC Heart Failure Guideline, which is expected to be published in late 2027. That guideline will translate the new definition into specific clinical recommendations for doctors treating patients with the condition.
