AIM: Physicians fall short of heart failure guidelines

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Despite the American Heart Association and American College of Cardiology guidelines that outline the most appropriate treatment for congestive heart failure, physicians are slacking on prescribing proper drug therapy that would be most beneficial, according to a study published in the Aug. 9/23 edition of the Archives of Internal Medicine.

According to the researchers, prescriptions for two heart failure drug therapies—angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), and beta-blockers—have steadily declined since the early and mid-2000s and only one-third of heart failure patients are benefiting from these types of treatments.

"Tried-and-true therapies are not getting the attention they really deserve," said senior author Randall S. Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center at Stanford Hospitals and Clinics in Stanford, Calif. "These therapies are of great value to the vast majority of heart-failure patients, and to see them being used in less than 40 percent of patients is a concern."

Dipanjan Banerjee, MD, and colleagues from Stanford used a database of physician survey responses to evaluate the trends of drug prescriptions to heart failure patients between 1994 and 2009.

Results of the study showed that while ACE-inhibitor and ARB prescriptions rose from 1994 to 2002 from 34 percent to 45 percent, by 2009, they decreased by 13 percent to 37 percent.

Additionally, beta-blocker use increased between 1998 and 2006 from 11 percent to 44 percent, but the numbers dropped to 37 percent by 2009.

"Our expectation was that there would be continued improvement in the use of these drugs, but that hasn't happened," Stafford said. "We're not sure what's gone wrong."

The researchers speculated that the drop in drug prescriptions for these patients could be due to the lack of clinical trials that outline the benefits of these types of treatment.

The study was funded by the National Heart, Lung and Blood Institute.