Targeting Other Modifiable Risk Factors for the Prevention of Heart Failure: Diabetes, Smoking, Obesity, and Inactivity

  • Timothy A. Gong
  • Shelley A. Hall
Heart Failure Prevention (S. Joseph, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Heart Failure Prevention


Purpose of Review

Prevention and reduction of risk factors is imperative in the battle against the heart failure epidemic. In this report, we update prior reviews with a focus on the modifiable risk factors of diabetes, smoking, obesity, and inactivity with regard to epidemiology, pathophysiology, management, and therapeutic options.

Recent Findings

While the incidence of diabetes is rising, recent trials suggest options for diabetic patients to prevent cardiovascular morbidity, mortality, and heart failure, with several more trials underway. We highlight several novel agents including sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor antagonists. Tobacco smoking significantly increases the risk for heart failure, and recent data show early cessation may be beneficial. Education, support mechanisms, and weaning tools are useful, but some patients may benefit from behavioral counseling and even pharmacotherapy. Obesity is well recognized for its role in the development of heart failure and contributes to standard cardiovascular risk factors, left ventricular hypertrophy, sleep apnea, and metabolic syndrome. Lifestyle changes are vital to impacting this condition and thus rely heavily on patient motivation and compliance. Newer medications for assistance with weight loss have been approved, while bariatric surgery may be necessary for some. Specific effects of physical activity on heart failure prevention are not well delineated and may differ for patients with diabetes.


Extensive efforts in patient education on self-management of their health, prevention and control of risk factors will be the ultimate solution to decreasing the incidence of heart failure in the future.


Heart failure Diabetes Smoking Tobacco use Obesity Prevention 


Compliance with Ethical Standards

Conflicts of Interest

Dr. Gong and Dr. Hall declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not describe studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. 1.Center for Advanced Heart and Lung DiseaseBaylor University Medical CenterDallasUSA
  2. 2.Annette C. and Harold C. Simmons Transplant InstituteBaylor Scott & White Research InstituteDallasUSA

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