What Medical Students Should Know About the 2017 Heart Failure Guideline Changes
Created August 17, 2017 by Guideline Central
As medical students, many of you are already aware that cardiovascular disease is the leading cause of death in US. Heart Failure (HF) prevalence alone has increased from 5.7 million to 6.5 million in Americans ≥ 20 years of age, and projections show prevalence will increase by 46% from 2012 to 2030 resulting in more than 8 million people 18 years of age and older with HF. For this reason, we are going to take a closer look at the major new recommendations from the ACC/AHA/HFSA 2017 Guidelines for Managing Patients with Heart Failure.
ACC and AHA have always been the “go to” sources for evidence-based best practices in the areas of heart failure and other cardiovascular diseases. The societies have published numerous iterations and updates to their heart failure guidelines over the last 20+ years, with the most recent update being released in May 2017. Using newly published evidence and study data, the 2017 update adds, elaborates on, and/or replaces a number of sections found in their last major heart failure guideline from 2014.
Let’s take a look at the most important changes you need to know about. The following guideline excerpts were provided compliments of Guideline Central:
1. The guidelines now prioritize prevention and also shine a brighter light on patients at risk for developing heart failure – people with hypertension, diabetes, or coronary artery disease.
2. In stable patients with mild to moderate heart failure and an adequate blood pressure and are otherwise tolerating standard therapies well, ACE inhibitors or ARBs should be switched to ARNI (sacubitril-valsartan). This is important, as other recent studies have shown that over 28,000 deaths could be prevented each year by simply following this one recommendation.
3. The optimal blood pressure numbers have once again been updated. This could be a good indication that the upcoming ACC/AHA Hypertension guidelines will also follow this new target.
4. New emphasis on comorbidities, including anemia and sleep disordered breathing.
Guideline Central has summarized these, and other clinical guidelines into a quick reference format which they are offering free to SDN members. The guideline summaries will allow you to quickly identify and understand the key points and decision variables. Not only will it save you time, but it will help you with your rotations and contribute to improved patient outcomes when the guidelines are followed.
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