Heart Failure: Stage A

University's Advanced Heart Failure Center

1350 Walton Way
Augusta, GA 30901-2629
Phone: 706-774-7855 
Fax. 706-364-0516 
Hours: 8 a.m.-4:30 p.m.


In Stage A, patients are at high risk for heart failure, but do not show any symptoms or have any structural damage to the heart. The first step in managing or preventing heart failure is to treat the primary conditions that cause or complicate heart failure. Risk factors include high blood pressure, heart diseases, diabetes, obesity, metabolic syndrome, and previous use of medications that damage the heart (such as some chemotherapy).

Important risk factors to manage include:

  • Coronary artery disease. Treatment includes a healthy diet, exercise, smoking cessation, medications, and possibly bypass surgery or angioplasty/stenting.
  • Cholesterol and lipid problems. Treatments include lifestyle management and medications, especially statin drugs.
  • High blood pressure. A normal systolic blood pressure is considered below 120 mm Hg, and a normal diastolic blood pressure is below 80 mm Hg. High blood pressure is diagnosed when measurements are 140/90 mm Hg or above. Reducing blood pressure can reduce the risk of developing heart failure.
  • Diabetes. The treatment of type 1 diabetes and type 2 diabetes is extremely important for reducing the risk for heart disease. ACE inhibitors are especially beneficial, particularly for people with diabetes. Research suggests that metformin, a drug used to treat diabetes, may also help prevent heart failure.
  • Obesity. Obesity affects cardiovascular health and should be considered and treated as a disease. Guidelines recommend that doctors create individualized weight loss plans for patients who are overweight or obese.
  • Valvular abnormalities, such as aortic stenosis and mitral regurgitation. Surgery may be required.
  • Abnormal health rhythms (arrhythmias). Ventricular assisted devices, notably biventricular pacers (BVPs), can help prevent hospitalizations for patients with these conditions.
  • Anemia. Patients with heart failure and underlying anemia should have their anemia corrected. On occasion, this may require erythropoiesis-stimulating drugs.
  • Thyroid function. Various medications are used to treat overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism).
  • Drugs. Avoid drugs that can worsen heart failure symptoms. Talk with your doctor about your heart failure before taking nonsteroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (verapamil and diltiazem), thiazolidinediones (drugs used for diabetes), anti-tumor necrosis factor medications, and most drugs used to treat irregular heart rhythms (arrhythmia).
  • Diet and Exercise. It is particularly important to reduce sodium (salt) intake to less than 2,400 mg a day (ask your doctor for specific sodium intake goals). Patients should engage in medically supervised exercise programs. Dietary changes and exercise are important for treating all stages of heart failure.