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March 7,  2002

Report Shows That Thousands of Heart Failure Patients May Not Be Receiving Ideal Therapy

Physicians Grade Heart Failure Management With Mediocre "C"

(SafetyAlerts) - Despite strong evidence that demonstrates the benefits of adding beta-blockers to standard therapy, thousands of heart failure patients are not receiving this class of drugs as part of their treatment regimens, according to a nationwide survey of 400 cardiologists, internists, and general practitioners, known as the Heart Failure Report Card. The survey, conducted in conjunction with the Cardiovascular Institute of University of Pittsburgh Medical Center (UPMC) Health System, showed that 87 percent of physicians polled say they clearly understand the benefits of beta-blockers as seen in clinical trials; however, this understanding isn't translating into practice -- physicians report that they prescribe beta-blockers to only one-third of their heart failure patients.

"We developed the Heart Failure Report Card to help us understand the current mindset and treatment patterns of physicians," said Arthur Feldman, M.D., Ph.D., Director of the Cardiovascular Institute of UPMC Health System in Pennsylvania. Physicians surveyed were asked to give letter-grade scores to various questions such as patient understanding of the disease, compliance with the necessary lifestyle changes, physician satisfaction with current medications and the availability of education about heart failure treatment options.

Overall, physicians graded heart failure diagnosis and treatment in the United States with a letter-grade of "C." Based on the responses of the surveyed physicians, researchers concluded that the key to optimizing heart failure treatment is education about the use of emerging therapies in clinical practice.

"Beta-blockers are valuable tools for managing heart failure," continued Dr. Feldman. "When used in conjunction with other medications, they have been shown to increase survival, potentially improve symptoms, enhance quality of life and decrease hospitalizations. Unfortunately, the Report Card findings show that most physicians are either not prescribing them, or are waiting until symptoms have substantially worsened to prescribe them. We need to educate both physicians and patients on the most effective ways to incorporate them into treatment regimens."

About Heart Failure

Heart failure begins when some other condition, a heart attack, high blood pressure, or a heart muscle disorder, damages the heart. It's a condition in which the heart fails to pump blood normally, causing symptoms such as fatigue, shortness of breath, swelling of feet or ankles and possibly, chest discomfort.

In the United States, approximately five million people have heart failure, with 550,000 new cases occurring each year. Heart failure results in almost one million hospitalizations each year and is the most common hospital discharge diagnosis in patients 65 years and older. It is the only major cardiovascular disorder that is increasing in incidence and prevalence, due to an aging population.

Beta-blockers improve heart function by reducing the heart's tendency to beat faster, a consequence of the heart's need to compensate for its weakened pumping action. When used in combination with diuretics, digoxin, or ACE inhibitors, beta-blockers can help decrease the symptoms of heart failure.

Living With Heart Failure

The Heart Failure Report Card also showed that physicians are giving their patients "low grades" in terms of their understanding of the disease and the lifestyle modifications necessary to manage the condition. Although heart failure can become quite severe, patients can manage it through appropriate treatment regimens and lifestyle changes, including reducing salt intake, exercising and monitoring weight daily. "Patients often don't understand issues surrounding heart failure diagnosis," said BJ Schneider, RN, research nurse coordinator at the Cardiovascular Institute of UPMC Health System. "The challenging part of dealing with these patients is helping them realize that heart failure is a treatable condition. By getting good care, watching their diet and following appropriate treatment regimens, including beta-blockers, they can reduce their symptoms and enjoy a more normal life."

The Heart Failure Report Card was conducted in conjunction with the Cardiovascular Institute of UPMC Health System, with an educational grant from AstraZeneca LP.

The Cardiovascular Institute offers heart disease prevention programs and primary cardiovascular disease management to help control the progression of heart disease. The Institute also offers drug- and device-based treatments for every type of heart and vascular disease, and rehabilitation programs for recovering coronary patients. In addition, the Cardiovascular Institute is involved in cutting edge research for congestive heart disease and ischemic heart disease.

Source: PRNewswire

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