Heart Failure Patients, Is Your Doctor Overlooking a Simple Life-Saving Treatment?

Only one out of three heart failure patients is sent home from the hospital with instructions to take a specific drug proven to prolong life and reduce hospitalization rates, according to the latest research.

In 2007, the American Heart Association estimated that 5.2 million in the U.S. had heart failure.  For perspective, the U.S. population is about 300 million.  At age 40, your risk of ever developing heart failure is one in five.

Five years after a diagnosis of heart failure, 50% of those so diagnosed have died.  And this is with treatment.  So heart failure is a serious marker of diminished lifespan.

The American College of Cardiology and the American Heart Association have issued evidence-based guidelines for treatment of heart failure that include a class of drugs called aldosterone antagonists.  By far the best-known drug in the class is spironolactone (brand name Aldactone, among others).  It's relatively cheap and well-tolerated.

Researchers with the Cleveland Clinic in Ohio analyzed over 43,000 patients admitted to one of 241 hospitals participating in the "Get With The Guidelines" quality improvement project.  They found that only one of every three candidates for aldosterone antagonists were prescribed the drug by the time of hospital discharge.  Moreover, in a large majority of cases they found no valid reasons for failure to prescribe.

The Take-Home Point

If you are a heart failure patient and not taking an aldosterone antagonist, ask your doctor why not.  She may have a good reason.  But it may be a simple oversight and she'll thank you for bringing it to her attention.  Don't hesitate to mention it: your life could depend on it.   

-Steve Parker, M.D.

Reference:  Albert, N.M., et al.  Use of aldosterone antagonists in heart failure.  Journal of the American Medical Association, 302 (2009): 1,658-1,665.