Stable but Progressive Nature of Heart Failure: Considerations for Primary Care Physicians

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
Inder Anand

Abstract

Primary care physicians play a significant role in managing heart failure (HF), with the goals of reducing mortality, avoiding hospitalization, and improving patients' quality of life. Most HF-related hospitalizations and deaths occur in patients with New York Heart Association functional class II or III, many of whom are perceived to have stable disease, which often progresses without clinical symptoms due to underlying deleterious effects of neurohormonal imbalance and endothelial dysfunction. Management includes lifestyle changes and stepped pharmacological therapy directed at the four stages of HF, with aggressive uptitration of therapies, including beta-blockers and inhibitors of the renin-angiotensin-aldosterone system. Recently, two new HF treatments have become available in clinical practice. Ivabradine was approved to reduce the risk of hospitalization for HF in patients with stable, symptomatic HF. Additionally, the angiotensin receptor-neprilysin inhibitor (ARNI), sacubitril/valsartan, was found to be significantly superior to enalapril in reducing risks of cardiovascular death and HF-related hospitalization. The respective 2016 and 2017 American College of Cardiology/American Heart Association/Heart Failure Society ...Continue Reading

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Citations

Jul 11, 2019·Journal of Comparative Effectiveness Research·Herminio Morillas-ClimentAlfonso Valle-Muñoz
Nov 30, 2019·Journal of Cellular and Molecular Medicine·Maria Paz OcaranzaLuis Farías
Feb 16, 2021·Frontiers in Bioengineering and Biotechnology·Andrew S Riching, Kunhua Song
Apr 27, 2021·Frontiers in Cardiovascular Medicine·Andrew J AccardiJames Thomas Heywood

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Methods Mentioned

BETA
HART

Clinical Trials Mentioned

NCT01131676
NCT01035255
NCT02441218
NCT01685840
NCT00303979
NCT00344513

Software Mentioned

OPTIMIZE
HF
SHIFT
IT
GDEM
GUIDE

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