Updated guidelines on the diagnosis and management of heart failure will help physicians incorporate the latest research findings into the treatment of patients with this complex and disabling disease.
The guidelines update was a joint effort of the American College of Cardiology (ACC) and the American Heart Association (AHA), and was accomplished in collaboration with the International Society for Heart and Lung Transplantation. The new document, a focused revision of guidelines released in 2005, was published online on 26 March, 2009 in the Journal of the American College of Cardiology (JACC) and Circulation: Journal of the American Heart Association.
“Heart failure is the number one reason patients over the age of 65 are hospitalised, and is responsible for a huge portion of the costs associated with cardiovascular disease,” said Dr Mariell Jessup, University of Pennsylvania School of Medicine in Philadelphia, and chair of the guidelines writing group. “We want to be sure the guidelines are current and timely, and reflect the latest data on the management of this important condition.”
The new document includes several key updates, including the following:
- An entirely new section on managing patients who are hospitalised with acute heart failure, including how to establish the cause of heart failure; the types of assessments to perform throughout the hospitalisation; and how to help patients successfully transition to home care, including a new medication regimen and an action plan for detecting signs of trouble and seeking medical attention right away;
- Strengthened recommendations on two medications, hydralazine and isosorbide dinitrate, which relieve pressure on the heart by relaxing blood vessels and are particularly effective in African-Americans;
- Streamlined information on the use of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronisation device;
- Clarification of treatment goals in patients with both heart failure and atrial fibrillation.
“These guidelines strive to reflect the most recent information coming out of clinical trials on heart failure,” said Jessup. “They also bring a new focus to patients hospitalised with heart failure. We look forward to continued research developments, so that the next update will be even more useful for guiding physicians.”