New research presented Aug. 28 during ESC Congress 2016 in Rome highlights opportunities to improve guideline-based care for heart failure (HF) patients.

Findings from a two-year, retrospective, observational study of 14,546 HF patients included in the UK Clinical Practice Research Datalink from 2009 to 2011 found that a large proportion of patients were not receiving guideline-recommended treatments. For example, European guidelines recommend that HF with reduced ejection fraction patients receive an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) combined with a beta-blocker, and, in a large number of patients, a mineralocorticoid receptor antagonist (MRA). While the study found 80 percent of patients were receiving an ACE inhibitor or ARB, only 57 percent were prescribed a beta-blocker and 31 percent were given a MRA. Additionally, the study found that of those patients receiving an ACE inhibitor or ARB, only 35 percent were receiving the target does, while only 20 percent of patients on a beta-blocker were on the recommended dose.

“One in five people will develop HF over their lifetime and 15 million people currently suffer from HF in Europe,” said lead author Pardeep Jhund, MD. “These findings emphasise the need to treat patients with HF using evidence-based, recommended therapies at doses that have been shown to be effective in clinical trials. This is vitally important considering the high costs of hospitalization and poor life expectancy associated with this condition.”

Closing gaps in care are especially necessary given results from a second study that suggests HF rates in the elderly are expected to triple by 2060. New data from the AGES-Reykjavík study show the number of elderly people according to age groups will increase in the coming decades, with the largest increases expected primarily in women and in the 70 to 79 years and 80 years and older age groups.

“The findings are a wake-up call for policy makers and health care providers that more needs to be done to prevent HF,” said lead author Ragnar Danielsen, MD. “This includes giving prompt treatment for heart attacks and encouraging adherence to preventative therapies and lifestyle changes afterwards.”

Similarly, new research out of the UK shows HF patients may have a 2 percent increased risk of dying with each admission to National Health Service hospitals. HF patients who had four to seven admissions to a hospital over the study period had an almost 20 percent increased risk of dying compared to those with one to three hospital admissions.

“Every effort should be made to start and/or optimize HF medications before patients leave hospital and ensure other interventions such as multidisciplinary community support are available for HF patients to reduce the risk of admission to hospital,” said lead author Rahul Potluri, MD. 

Keywords: ESC Congress, Adrenergic beta-Antagonists, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Health Personnel, Heart Failure, Hospitalization, Life Expectancy, Life Style, Mineralocorticoid Receptor Antagonists, Myocardial Infarction, National Health Programs, Retrospective Studies

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