Translating the 2023 Malaysian Heart Failure Clinical Practice Guidelines (5th Edition) into primary care practice.

Heart failure (HF) is a major public health concern in Malaysia, with increasing prevalence and significant morbidity and mortality. The 2023 Malaysian HF Clinical Practice Guidelines (CPGs) (5th Edition) provide updated, evidence-based recommendations tailored for local practice, particularly in primary care, where long-term management often occurs. Compared with international guidelines, the Malaysian CPGs adopt age-specific natriuretic peptide (NP) thresholds to improve diagnostic specificity while acknowledging that diagnosis may still depend primarily on clinical assessment supported by electrocardiogram (ECG) and chest radiography in resource-limited settings. This article provides a narrative educational review that summarises the core recommendations of the Malaysian HF CPGs, compares them with international guidelines and illustrates their application in primary care through two case vignettes representing different HF classifications. We aim to provide practical application of Malaysian CPG recommendations in primary care, emphasising the need for primary care physicians to initiate foundational HF therapies early and titrate them to target or maximally tolerated doses while ensuring their continuation in the long term to prevent relapse and preserve ventricular function. In addition, the availability of NP testing, diastology studies and structured titration protocols in primary care would strengthen early diagnosis and systematic optimisation of therapy, ultimately improving outcomes for patients with HF.