doi:10.5402/2012/982417 Review Article Primary Prevention of Heart Failure

permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Most heart failure research and quality improvement efforts are targeted at treatment and secondary prevention of patients with manifest heart failure. This is distinct from coronary disease where primary prevention has been a focus for over three decades. Given the current importance and the projected worsening of heart failure epidemiology, a more focused effort on prevention is urgently needed. 1. Epidemiology It is estimated that over 5.5 million subjects in the United States have heart failure and more than 650,000 are diag-nosed for the first time each year [1]. Patients with impaired versus preserved left ventricular systolic function related heart failure each comprises about half of the overall burden of heart failure in the community [2, 3]. The proportion of heart failure with preserved ejection fraction increases with age [2]. Heart failure is the primary reason for 12–15 million office visits and 6.5 million hospital days annually