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"
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
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
"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
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
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.