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Treatment with angiotensin converting enzyme inhibitors, angiotensin-II-antagonists and beta-blockers in an unselected group of patients with chronic heart failure

  • Pharmacoepidemiology and Prescription
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Abstract

Objectives

Modern diagnostics of chronic heart failure (CHF) is based on echocardiography. Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-II-antagonists (AIIAs) in case of ACEI intolerance, and beta-blockers are recommended as first-line drugs in patients with CHF and left ventricular systolic dysfunction. The aims of this study were to analyse the diagnostics and treatment of patients with CHF and to identify the optimal drug profile (target level) with regard to ACEI/AIIA- and beta-blocker treatment.

Methods

The medical records of all patients (n=635) from a part of a Swedish county who had a diagnosis of CHF in the year 2000 were analysed retrospectively.

Results

The prevalence of CHF increased with age, from 0.9% and 1.6% in the age group 60–64 years in women and men, respectively, to 8.8% and 11.5%, respectively, in the age group 80–84 years. Only 17.6% of the patients had been examined by means of echocardiography. Of the patients without any contra-indication for the drugs, 45.9% received treatment with ACEI/AIIAs and 41.8% with beta-blockers. Treatment with ACEI/AIIAs and beta-blockers was given to 21.3%. The corresponding proportions for treatment of patients with CHF verified by echocardiography were 88.0% (ACEI/AIIA), 52.0% (beta-blocker) and 46.7% (the combination). The target level of the combination treatment was estimated to be about 70% in a group of unselected patients with CHF.

Conclusions

CHF was not optimally diagnosed in this cohort of patients. Correct diagnosing seems to be associated with more adequate treatment.

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Acknowledgements

The present study was financially supported by the Federation of Swedish County Councils. The study complies with the current laws of Sweden, including the law of ethics.

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Authors and Affiliations

  1. Department of Medicine, Kristinehamn’s Hospital, Kristinehamn, Sweden

    Ragnar Watz, Ann-Britt Ekstrand & Victoria Engelbrektson

  2. Medical Products Agency, Uppsala, Sweden

    Björn Beermann

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  1. Ragnar Watz
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  2. Ann-Britt Ekstrand
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  3. Victoria Engelbrektson
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  4. Björn Beermann
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Correspondence to Björn Beermann.

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Watz, R., Ekstrand, AB., Engelbrektson, V. et al. Treatment with angiotensin converting enzyme inhibitors, angiotensin-II-antagonists and beta-blockers in an unselected group of patients with chronic heart failure. Eur J Clin Pharmacol 61, 209–214 (2005). https://doi.org/10.1007/s00228-005-0892-y

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  • DOI: https://doi.org/10.1007/s00228-005-0892-y

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