Abstract
Surveys of prescribing patterns in both hospitals and primary care have usually shown delays in translating the evidence from clinical trials of pharmacological agents into clinical practice, thereby denying patients with heart failure (HF) the benefits of drug treatments proven to improve well-being and prolong life. This may be due to unfamiliarity with the evidence-base for these therapies, the clinical guidelines recommending the use of these treatments or both, as well as concerns regarding adverse events. ACE inhibitors have long been the cornerstone of therapy for systolic HF irrespective of aetiology. Recent trials have now shown that treatment with beta-blockers, aldosterone antagonists and angiotensin receptor blockers also leads to substantial improvements in outcome. In order to accelerate the safe uptake of these treatments and to ensure that all eligible patients receive the most appropriate medications, a clear and concise set of clinical recommendations has been prepared by a group of clinicians with practical expertise in the management of HF. The objective of these recommendations is to provide practical guidance for non-specialists, in order to increase the use of evidenced based therapy for HF. These practical recommendations are meant to serve as a supplement to, rather than replacement of, existing HF guidelines.
MeSH terms
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Adrenergic beta-Antagonists / administration & dosage
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Adrenergic beta-Antagonists / therapeutic use*
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Angiotensin Receptor Antagonists*
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Angiotensin-Converting Enzyme Inhibitors / administration & dosage
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
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Benzimidazoles / administration & dosage
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Benzimidazoles / therapeutic use
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Benzopyrans / administration & dosage
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Benzopyrans / therapeutic use
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Biphenyl Compounds
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Bisoprolol / administration & dosage
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Bisoprolol / therapeutic use
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Captopril / administration & dosage
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Captopril / therapeutic use
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Carbazoles / administration & dosage
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Carbazoles / therapeutic use
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Carvedilol
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Drug Therapy, Combination
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Enalapril / administration & dosage
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Enalapril / therapeutic use
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Ethanolamines / administration & dosage
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Ethanolamines / therapeutic use
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Evidence-Based Medicine*
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Guideline Adherence
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Heart Failure / drug therapy*
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Heart Failure / physiopathology
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Humans
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Indoles / administration & dosage
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Indoles / therapeutic use
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Lisinopril / administration & dosage
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Lisinopril / therapeutic use
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Metoprolol / administration & dosage
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Metoprolol / analogs & derivatives
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Metoprolol / therapeutic use
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Mineralocorticoid Receptor Antagonists / therapeutic use*
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Nebivolol
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Practice Guidelines as Topic*
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Propanolamines / administration & dosage
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Propanolamines / therapeutic use
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Ramipril / administration & dosage
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Ramipril / therapeutic use
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Spironolactone / therapeutic use
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Stroke Volume
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Tetrazoles / administration & dosage
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Tetrazoles / therapeutic use
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Valine / administration & dosage
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Valine / analogs & derivatives
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Valine / therapeutic use
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Valsartan
Substances
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Adrenergic beta-Antagonists
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Angiotensin Receptor Antagonists
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Angiotensin-Converting Enzyme Inhibitors
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Benzimidazoles
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Benzopyrans
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Biphenyl Compounds
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Carbazoles
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Ethanolamines
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Indoles
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Mineralocorticoid Receptor Antagonists
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Propanolamines
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Tetrazoles
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Nebivolol
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Carvedilol
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trandolapril
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Spironolactone
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Enalapril
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Valsartan
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Captopril
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Lisinopril
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Metoprolol
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Valine
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Ramipril
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candesartan
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Bisoprolol