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    Underused Treatments Could Save Lives From Heart Failure

    Study Shows Thousands of Lives Could Be Saved From Treatments Such as Beta-Blockers
    WebMD Health News
    Reviewed by Laura J. Martin, MD

    June 8, 2011 -- Close to 70,000 heart failure deaths could be prevented in the U.S. each year if more patients were on recommended therapies, new research suggests.

    The study is among the first to quantify the impact, in terms of lives saved, of broader use of drug and cardiac device treatments for heart failure.

    About 6 million people in the U.S. have heart failure and roughly 282,000 die of the disease each year, according to the CDC.

    The condition occurs when the heart is unable to pump enough blood and oxygen to other organs. Common symptoms include shortness of breath during normal activity, water retention leading to swelling, and general fatigue and weakness.

    Six heart failure therapies, including four drug and two nondrug treatments, have been proven to reduce deaths and are recommended by the American College of Cardiology and the American Heart Association for patients with reduced left-ventricle ejection fraction.

    These treatments include:

    • ACE inhibitors or angiotensen II receptor blockers (ARBs)
    • Beta-blockers
    • Aldosterone hormone-targeting diuretics known as aldosterone antagonists
    • Hydralazine/isosorbide dinitrate
    • Cardiac resynchronization therapy (CRT), which involves the implantation of a specialized pacemaker or a combination device that also includes a defibrillator
    • Implantable cardiac defibrillator (ICD), which detects and corrects cardiac arrhythmias

    Aldosterone Antagonists

    Not all the treatments are appropriate for all patients, but guidelines call for them to be considered when indicated.

    In their effort to explore the use of these six heart failure therapies, University of California, Los Angeles heart researcher Gregg C. Fonarow, MD, and colleagues examined clinical trials, inpatient and outpatient heart failure registries, and heart failure quality-of-life studies.

    They found that out of about 2.6 million patients with reduced left-ventricular ejection fraction in the U.S., the largest number were eligible for and treated with for ACE inhibitor/ARB and beta-blocker therapy, while the smallest number were eligible for and treated with hydralazine/isosorbide dinitrate.

    About 80% of eligible patients were prescribed ACE inhibitors/ARBs, and 86% were prescribed beta-blockers, but only 36% of patients eligible for aldosterone antagonists were on the drugs.

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