Heart Failure Treatment Underused

Two-thirds of patients in U.S. hospitals fail to get recommended therapy, study finds

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TUESDAY, Oct. 20, 2009 (HealthDay News) -- A recommended treatment for heart failure is underused in U.S. hospitals, a new study finds.

The use of aldosterone antagonist therapy in patients with heart failure is designated as "useful and recommended" in chronic heart failure guidelines established by the American College of Cardiology/American Heart Association (ACC/AHA), but this study found that less than one-third of patients hospitalized for heart failure receive the treatment.

Researchers analyzed data on 43,625 patients admitted with heart failure and discharged home from 241 hospitals participating in a hospital recognition program called Get With The Guidelines -- HF between 2005 and 2007.

The study found that 12,565 patients (28.8 percent) from 201 hospitals met ACC/AHA heart failure management guidelines criteria, and 4,087 eligible patients received an aldosterone antagonist when they were discharged from hospital. Overall, treatment increased from 28 percent to 34 percent during the study period, but there was wide variation in aldosterone antagonist use among hospitals -- ranging from 0 percent to 90.6 percent.

"Aldosterone antagonist use in eligible patients was associated with younger age, African-American race/ethnicity, lower systolic blood pressure, history of implantable cardioverter-defibrillator use, depression, alcohol use and pacemaker implantation, and with having no history of renal insufficiency," wrote Nancy M. Albert of the Cleveland Clinic and colleagues.

"These data confirm that in the context of a hospital-based performance improvement program, aldosterone antagonist therapy can be used according to guidelines with little inappropriate use. Given the substantial morbidity and mortality risk faced by patients hospitalized with HF and the established efficacy of aldosterone antagonist prescription in HF, a stronger uptake of aldosterone antagonist therapy indicated by evidence-based guidelines may be warranted," the researchers concluded.

The study was published in the Oct. 21 issue of the Journal of the American Medical Association.

More information

The American Heart Association has more about heart failure.

SOURCE: Journal of the American Medical Association, news release, Oct. 20, 2009

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