New strategies for improving heart failure management: a primary care perspective.

Abstract:

:Most patients with heart failure today are treated by primary care practitioners, not cardiologists. The Consensus Recommendations for the Management of Chronic Heart Failure, developed by the Advisory Council to Improve Outcomes Nationwide in Heart Failure, provide practice guidelines for the prevention, diagnosis, and treatment of heart failure. Although hemodynamic abnormalities contribute to the symptoms of heart failure, disease progression is attributable to neurohormonal abnormalities, primarily activation of the renin-angiotensin system and the sympathetic nervous system. Pharmacologic treatment that antagonizes these neurohormonal abnormalities reduces the morbidity and mortality associated with heart failure. Guidelines recommend that patients with systolic dysfunction and symptoms of fluid retention receive a diuretic followed by an angiotensin-converting enzyme inhibitor, and, once the patient is euvolemic, a beta-blocker. Digoxin may be added to therapy for patients with persistent symptoms or rapid atrial fibrillation. Clinical trials have shown that such combination regimens reduce the risk of hospitalization and death in patients with heart failure.

journal_name

South Med J

journal_title

Southern medical journal

authors

Basile J

subject

Has Abstract

pub_date

2001-02-01 00:00:00

pages

166-74

issue

2

eissn

0038-4348

issn

1541-8243

journal_volume

94

pub_type

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