# Vroege, parallelle start van CVKM-medicatie voorkomt hartfalen — EJHF-consensus

*geplaatst 2026-10-09 · Nierziekte · European journal of heart failure · doi 10.1093/ejhf/xuag301 · https://hartvaat.nl/2026/10/01/vroege-parallelle-start-van-cvkm-medicatie-voorkomt-hartfalen-ejhf-consensus/*

Een nieuwe consensus van de European Journal of Heart Failure benadrukt de noodzaak van vroege, parallelle start van bewezen hartfalenpreventieve medicatie (SGLT2-remmers, non-steroïde MRA's, GLP-1-agonisten en RAS-remmers) bij patiënten met het cardiovasculair-nier-metabool (CVKM)-syndroom. De auteurs pleiten voor een versnelde implementatie, gestructureerde monitoring en multidisciplinaire zorgpaden om klinische inertie en toegankelijkheidsbarrières te doorbreken. Voor cardiologen, internisten en huisartsen betekent dit een duidelijke verschuiving naar proactieve, cross-specialistische preventie van hartfalen in plaats van reactief behandelen.

## English: Pharmacological treatment strategies to prevent heart failure across the cardiovascular-kidney-metabolic spectrum: an EJHF Expert Consensus Statement.

An expert consensus from the European Journal of Heart Failure recommends early, parallel initiation of proven pharmacotherapies (SGLT2 inhibitors, non-steroidal MRAs, GLP-1 receptor agonists, and RAS inhibitors) to prevent heart failure across the cardiovascular-kidney-metabolic spectrum. The statement calls for accelerated implementation, structured monitoring, and multidisciplinary care pathways to overcome clinical inertia and access barriers. For clinicians in cardiology, internal medicine, and primary care, this represents a paradigm shift toward proactive, cross-specialty prevention rather than reactive management of established heart failure.

## Abstract (original, from the publication)

Heart failure (HF) remains a major cause of morbidity, mortality, and increased healthcare costs worldwide, and is recognized as the result of progressive cardiovascular-kidney-metabolic (CKM) syndrome. Obesity, type 2 diabetes, chronic kidney disease, hypertension, and atherosclerotic cardiovascular disease frequently coexist and interact through shared pathophysiological mechanisms that promote HF onset, especially with preserved ejection fraction (HFpEF). This European Journal of Heart Failure (EJHF) Expert Consensus Statement synthesizes contemporary evidence supporting pharmacological strategies to prevent HF across the CKM spectrum. Foundational therapies, including renin-angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and incretin-based agents, demonstrate complementary benefits in reducing HF events, cardiovascular death, and chronic kidney disease (CKD) progression in high-risk populations. Early, parallel initiation of these therapies may modify disease trajectory and attenuate progression from at-risk and pre-HF stages to overt clinical HF. This document further emphasizes the need for an up-front, accelerated implementation strategy supported by structured monitoring, multidisciplinary CKM care pathways, and proactive management of laboratory abnormalities. Overcoming barriers such as clinical inertia, safety misperceptions, polypharmacy, cost constraints, and inequities in access is essential to translate evidence into population-level impact. Harmonization of prevention frameworks across cardiology, nephrology, endocrinology, and primary care societies is urgently required. Integrated, cross-disciplinary implementation of evidence-based CKM management offers a realistic opportunity to reduce incident HF and mitigate its growing global burden.

Auteurs: Riccardo M Inciardi, Amr Abdin, Magdy Abdelhamid, Giuseppe Ambrosio, Michael Böhm, Antonio Cannata, Ovidiu Chioncel, Francesco Cosentino, Alberto Esteban-Fernandez, Ahmed Elsanhoury, Nicolas Girerd, Pardeep S Jhund, Felix Lindberg, Sophie Van Linthout, Carlo M Lombardi, Brendon L Neuen, John W Ostrominski, Davide Stolfo, Muthiah Vaduganathan, Scott D Solomon, Wilfried Mullens, Marco Metra, Gianluigi Savarese

---
Bron: European journal of heart failure, https://doi.org/10.1093/ejhf/xuag301. Bijgewerkt 2026-10-02T01:30:44Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.