ACC/AHA update heart failure guidelines; new advice for hospitalized

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The American College of Cardiology (ACC) and the American Heart Association (AHA) have released updated guidelines on the diagnosis and management of heart failure to help physicians incorporate the latest research findings into treating these patients.

The new document, which revises guidelines released in 2005, is published online today in the Journal of the American College of Cardiology and Circulation.

"Heart failure is the number one reason patients over the age of 65 are hospitalized, and is responsible for a huge portion of the costs associated with cardiovascular disease," said Mariell Jessup, MD, chair of the guidelines writing group and a professor of medicine at the University of Pennsylvania School of Medicine in Philadelphia. "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 updates, including:

  • A new section on managing patients who are hospitalized with acute heart failure, including how to establish the cause of heart failure; the types of assessments to perform throughout the hospitalization; and how to help patients successfully transition to home care, including a new medication regimen and 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 effective in African Americans;
  • Streamlined information on the use of implantable cardioverter defibrillators and cardiac resynchronization devices; and
  • 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, who is also director of the Heart Failure and Transplant Program of the University of Pennsylvania Health System in Philadelphia. "They also bring a new focus to patients hospitalized with heart failure. We look forward to continued research developments, so that the next update will be even more useful for guiding physicians."

Some 5.7 million Americans have heart failure, a condition that accounts for more than 1.1 million hospitalizations each year, according to the associations. One in five people die within a year of being diagnosed with heart failure. In 2009, it is estimated that total costs associated with heart failure will reach $37.2 billion.