Heart failure presents a growing public health problem both in Estonia and across Europe. At the same time, its timely detection is often challenging. Together with international colleagues, Laura Lõo, Junior Research Fellow of Public Health at the University of Tartu, has developed new models that help identify disease risk even before symptoms appear.
Cardiovascular diseases place a heavy burden on the healthcare system and account for nearly half of all deaths in Estonia. “Despite these worrying statistics, the prevention of heart disease has so far not been sufficiently systematic, and heart failure is often detected only when a person visits a doctor for another reason,” said Lõo. “It is therefore crucial that treatment reaches the right people at the right time.”
Based on large international health databases, researchers developed two heart failure risk assessment models, the reliability of which was tested using data from the Estonian Biobank.
The first model, SCORE2-HF , is intended for the early detection of the disease in the general population and enables to estimate up to 30-year risk of heart failure.
The risk assessment is based on several routinely collected health indicators, such as blood pressure and body mass index. Important risk factors also include smoking, type 2 diabetes, and the use of hypertension medication.
The development of the model made use of BIG‑HEART, a unique nationwide database that includes health and social data on all people aged over 36 living in Estonia in 2012. In total, health indicators from nearly 700,000 Estonians were used in developing the model.
“Although Estonia is a small country, it is extremely gratifying to see that we can successfully contribute to major international research projects with our data,” Lõo emphasised.
The second model, SMART2-HF , is designed for people with a history of cardiovascular disease. The model is based on patients’ medical records and allows to assess the risk of developing heart failure over the next ten years.
The research findings also indicate that the risk of heart failure is not evenly distributed across Europe. The analysis shows that risk levels are higher in Eastern and Central Europe, including Estonia, compared with Western Europe.
According to Lõo, these differences may be explained by the wider prevalence of risk factors as well as lifestyle patterns. Historical and social factors may also have a role. For example, previous studies have linked Soviet-era patterns, such as smoking and excessive alcohol consumption, to present-day health behaviours.
At the same time, the variation between countries highlights the importance of early prevention and risk assessment within the Estonian healthcare system.
The new risk models have the potential to be adopted into everyday clinical practice, helping doctors to better assess patients’ disease risk and to make targeted treatment decisions on that basis. According to Lõo, it is likely that at least the SCORE2-HF model will be recommended in future clinical practice guidelines of the European Society of Cardiology.
Articles presenting the models, “Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2 ‑ HF model” and “Prediction of incident heart failure in individuals without prior cardiovascular disease: the SCORE2 ‑ HF risk model” , were published in European Heart Journal .
European Heart Journal
Data/statistical analysis
People
Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2-HF model
11-Mar-2026
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