ACC, AHA, HFSA 2022 Heart Failure Management Guidelines: A Guideline Topline

The new HF guidelines prioritize primary prevention, revise disease stages to encourage early intervention, and now include SGLT2i as guideline-directed medical therapy.

The new 2022 guidelines on management of heart failure reflect a unique collaboration between the American College of Cardiology, American Heart Association, and the Heart Failure Society of America.

The new recommendations retain and combine elements from guidelines published in 2013 and 2017 and, based on extensive review of new data, include important evidenc-based additions and revisions. Top among the new recommendations is a Class 2a recommendation for use of SGLT-2 inhibitors in HFpEF and revised ACC/AHA stages of heart failure.

For primary care clinicians the revised staging of heart failure reinforces a primary focus of the new guidlines on prevention of heart failure; thus the new Stage A: At-risk for heart failure emphasizes early identification of and treatment to reduce risk factors that include a range of cardiometabolic disease.

The Guideline Topline that follows includes the new stages of heart failure and a quick look at the 10 topline guidlines take-home points identified by the writing committe.

Reference: Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guidline for management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am COll Cardiol. 2022. Published online and available at

Published simultaneously in Circulation and the Journal of Cardiac Failure.