Abstract Background DAHNA (Diet According to the Healthy Heart Nutritional Approach) is an integrated and innovative mobile app that allows for: 1. Screening of atherosclerotic cardiovascular disease (ASCVD) risk; 2. A personalized healthy diet (macro- and micronutrients) based on cardiometabolic screening; 3. Long-term management of major risk factors; 4. Highly incentivizing rewards within the app. Objective To present the functionalities, mode of operation, and initial results of DAHNA through public implementation. Methods DAHNA can be downloaded on mobile phones (iOS and Android). Firstly, the app assesses the user's ASCVD risk score based on their country of residence using a "one-size-fits-all" risk calculator that combines the 2021 European Society of Cardiology (ESC) SCORE2/SCORE2-OP scores and the American Heart Association (AHA) Framingham score. For Europe, the calculation is based on the four SCORE2/SCORE2-OP tables for the four risk regions. DAHNA is not limited to healthy individuals and allows the user to indicate if they have diabetes, chronic kidney disease, or ASCVD. Secondly, based on the individual ASCVD risk score, DAHNA offers the following features: 1. Personalized healthy menus (Mediterranean diet) based on the only macro- and micronutrients proven to reduce individual ASCVD risk and in the recommended daily dose, with an automatically generated ingredient list and quantities; the user can choose to purchase the ingredients personally or order the list from suppliers; 2. Periodic follow-up of ASCVD risk outcomes; 3. Display of healthy life minutes gained by the user; 4. Notifications, reminders, rewards within the app, personalized weight loss plans, PDF reports to share with healthcare teams, and nutritional education; 5. A recommendation for a medical examination for those with high or very high risk; 6. Short movies to introduce physical activity and up-to-date medical information; 7. All data is collected in a central database. Results Between August 10th, 2022 and February 12th, 2023, 19,780 users downloaded DAHNA (mean age 48 +/- 10 years, 58% females, 11.13% with diabetes, 15.16% smokers, 16.4% with hypertension; 14% had low-to-moderate risk, 40% had high risk, and 46% had very high risk). A 100% correspondence was confirmed between the results of the DAHNA calculator and the ESC tables. Conclusion 1. DAHNA self-screening showed that 86% of users belong to the high or very high ASCVD risk group, which is consistent with statistical data showing Romania among the countries with a very high ASCVD risk. 2. This app is the first to assign a personalized healthy diet based on specific micronutrients to control ASCVD risk, provide medical recommendations for a healthy lifestyle, and allow for real-time management of major risk factors and ASCVD risk in large populations. These data should be important for adjusting health policies.

Contact address: Ovidiu Chioncel, MD PhD FHFA “C.C.Iliescu” Emergency Institute for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania E-mail: ochioncel@yahoo.co.uk INTRODUCTION Heart failure (HF) is a clinical syndrome that represents the common manifestation of diverse cardiac and noncardiac pathologies. HF represents a condition with a negative impact on both the individual, because of lost years of life and by altering the quality of life, and on the health system, by raising the fi nancial and social costs. In spite of increased survival, HF prevalence will continue to increase because of the ageing population and the increase in survival following acute conditions (myocardial infarction, acute valvular diseases). Recent data of the European Heart Failure Association has shown that 26 millions of people have been diagnosed with HF, worldwide, and 3,6 million are newly diagnosed each year, only in Europe1. In Romania, the picture is even more dramatic a percentage as high as 4,7% of the general population above 35 years, are diagnosed with HF2. Epidemiological data on HF is missing in many countries, because of the absence of relevant observational studies, to capture the incidence, prevalence, prognosis and main causes for HF. The understanding of the epidemiology and the clinical characteristics of HF in a certain population is key issue in improving prognosis. Randomized clinical trials bring important epidemiological information, but its generalization and applicability are limited by the very strict inclusion and exclu-