World Heart Day Highlight: Redefining Heart Failure, Working Towards Prevention

“Don’t Miss a Beat” is the global theme for World Heart Day this year, focusing on raising public awareness of the impact of cardiovascular (heart) diseases and prevention methods. Sadly, according to the World Heart Federation (WHF), one in five people globally will die prematurely from heart disease.1 In 2026, heart disease is also still one of the leading causes of death for Jamaicans.2 In honor of World Heart Day, Dr. Ahmed Soliman Hegazy highlights a recent shift in how cardiologists worldwide think about “heart failure.”

What is heart failure?

In simple terms, according to Dr. Soliman Hegazy, “If we consider the heart to be the engine of the body, heart failure is like engine failure; it means the pumping power of the heart is not as good as it should be, which affects the patient’s energy and performance in every aspect.”

When the heart can’t pump blood efficiently, the patient experiences fatigue, shortness of breath after exertion, and, in later stages, fluid buildup in the legs or lungs.3 However, cardiologists have long debated how to effectively categorize types of heart failure. Stakeholders, including researchers, policymakers, and healthcare professionals, need standard categories to determine and support best practices for patient care.

The Second Universal Definition of Heart Failure

In June 2026, major global heart organizations such as the American Heart Association, the European Society of Cardiology, and the World Heart Federation collaborated to release the Second Universal Definition of Heart Failure.4 This Second Universal Definition reaffirms and updates the First Universal Definition (created in 2020).5

The First Definition emphasized measuring heart failure based on left ventricular ejection fraction (LVEF). LVEF is a measure of how much blood the left ventricle of the heart pumps over time. The Second Universal Definition introduces a standardized classification of heart failure causes into the diagnostic framework. “Ejection fraction is still used in defining heart failure, but expanding the framework is helpful because it’s more logical,” Dr. Soliman Hegazy notes. “For a long time we have had a category called ‘heart failure with preserved ejection fraction’, where the ejection fraction is within normal range but other physical symptoms like fluid build-up indicate heart failure. That was one of the debates between cardiologists, if we are still having heart failure with preserved ejection fraction, that means that the heart can fail with normal function, so the function itself is not the problem.” Dr. Soliman Hegazy explains that studies on diseases like hypertension, diabetes, and chronic kidney disease (CKD) show that they contribute to heart failure even in cases where ejection fraction is preserved.

Will this affect how doctors treat patients in Jamaica?

“The definition has shifted because we understand more about the problem, but in many cases it does not change much about the day-to-day management of the problem,” says Dr. Soliman Hegazy. “It is a fine-tuning of how we manage these conditions, rather than a complete shift.”

He notes that new research shows that some medicines that have long been used to control chronic conditions such as diabetes and CKD can also help the symptoms of heart failure. Much remains unknown about why the heart fails, especially in conditions where pumping function is maintained, but this new way of thinking about heart failure allows doctors to treat underlying conditions as a way to treat heart failure itself, and expands how certain medications can be used.

Dr. Soliman Hegazy notes that there are not many cardiologists in Jamaica, and they tend to be concentrated in Kingston. So cardiologists should do their best to share knowledge of the new treatment framework with general practitioners, especially outside Kingston, who often treat heart patients before they see a specialist. Doctors need to understand specifically which medications (that they may have used for other conditions) are now approved to treat heart failure.

How can everyday Jamaicans work to prevent heart failure?

“Heart failure is not something that comes all of a sudden; it reflects a long history of something ongoing, that then leads to heart failure at the end,” says Dr. Soliman Hegazy. “If we are talking about a patient who develops heart failure in his 20’s or 30’s, that means he had a problem from a long time before, but nobody took care of that.”

It is more pertinent than ever to think about preventing heart disease at all ages, because the earlier appropriate treatment is administered, the better the possible outcomes.

Some things you can do to help prevent heart failure include:

• Take children for a general heart screening early in life to check for possible childhood heart conditions such as rheumatic heart disease.
• At all ages, practice healthy habits like avoiding smoking; getting regular exercise; and eating a healthy, balanced diet.
• All adults, especially those over 40, should get yearly executive profile blood tests to check whether their blood sugar, blood pressure, and cholesterol levels are within a normal range. If these numbers are outside the range, they should get appropriate, early treatment.
• Learn and look out for the symptoms of heart failure. Heart failure can affect people of all ages, but it can be easily missed, especially in younger patients. If you are experiencing fatigue, shortness of breath after exertion, and persistent weakness, a doctor should do an echocardiogram (ECG) to eliminate the possibility of heart failure.

References

1. World Heart Federation — World Heart Day
2. Heart disease still among Jamaica’s biggest killers, warns cardiologist — Jamaica Gleaner
3. Heart Failure: Understanding Heart Failure — Cleveland Clinic
4. Global experts update heart failure definition to improve prevention, diagnosis and care — American Heart Association
5. Universal Definition and Classification of Heart Failure — American College of Cardiology