Risk scores for heart failure: powerful for populations, problematic for the individual patient

This editorial refers to ‘Risk prediction in patients with heart failure with preserved ejection fraction: the LIFE-Preserved model’, by T.H. Reitsma et al., https://doi.org/10.1093/eurheartj/ehag182; ‘Prediction of incident heart failure in individuals without prior cardiovascular disease: the SCORE2–HF risk model’, by S. Kaptoge et al., https://doi.org/10.1093/eurheartj/ehag154 and ‘Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2–HF model', by T.H. Reitsma et al., https://doi.org/10.1093/eurheartj/ehag153. In recent years, cardiovascular medicine has seen a rapid expansion of risk prediction tools intended to guide prevention and management. The SCORE2 and SCORE2-OP models for atherosclerotic cardiovascular disease, alongside other contemporary equations for cardiometabolic risk, have reinforced the appeal of quantitative risk estimation as a basis for clinical and policy decisions.1 Against this background, three papers published in this issue of the European Heart Journal extend risk prediction decisively into the domain of heart failure, addressing populations without prior cardiovascular disease (SCORE2-HF), individuals with established atherosclerotic cardiovascular disease (SMART2-HF), and patients with heart failure with preserved ejection fraction (LIFE-Preserved).2–4.