Heart failure (HF) is a broad term that encompasses many different etiologies and degrees of cardiac dysfunction, but generally refers to impairment of blood flow through the heart. Americans over 40 have a 20% lifetime risk of developing HF. It is associated with considerable morbidity and mortality, and accounts for approximately 1M hospitalizations annually; it is also a major cause of hospital readmission. The 2013 ACC/AHA Guideline for the Management of Heart Failure (with focused updates in 2016 and 2017) offers a comprehensive guide to treating this common condition.
Note: HFrEF and HFpEF are not mutually exclusive | Patients often have combined systolic and diastolic dysfunction
Guideline-directed medical therapy (GDMT) Is Tailored According to Severity of Disease
ACE inhibitors (ACEI): Associated with mortality benefit
Beta blockers: Associated with mortality benefit
Aldosterone antagonists: Mortality benefit for NYHA II-IV with EF≤35%
Loop diuretics: Indicated for Stages C-D for relief of symptoms due to fluid overload; no known effect on mortality
Drugs to avoid
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