Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure/2013 ACC/AHA Guideline, 2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1][2]
Hypertension in Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. In patients at high risk for developing heart failure, systolic and diastolic hypertension should be controlled in accordance with contemporary guidelines. [4][5][6][7](Level of Evidence: A) " |
| "2. In patients at increased risk, stage A HF, the optimal blood pressure in those with hypertension should be less than 130/80 mm Hg.[8][9] (Level of Evidence: B-R) " |
| Class IIa |
| "1. Angiotensin converting enzyme inhibitors can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: A) " |
| "2. Angiotensin II receptor blockers can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: C) " |
Diabetes Mellitus in Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. For patients with diabetes mellitus (who are all at high risk for developing heart failure), blood sugar should be controlled in accordance with contemporary guidelines. (Level of Evidence: C) " |
| Class IIa |
| "1. Angiotensin converting enzyme inhibitors can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: A) " |
| "2. Angiotensin II receptor blockers can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: C) " |
Metabolic Syndrome in Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. In patients at high risk for developing heart failure, systolic and diastolic hypertension should be controlled in accordance with contemporary guidelines. (Level of Evidence: A) " |
| "2. In patients at high risk for developing heart failure, lipid disorders should be treated in accordance with contemporary guidelines. (Level of Evidence: A) " |
| "3. For patients with diabetes mellitus (who are all at high risk for developing heart failure), blood sugar should be controlled in accordance with contemporary guidelines. (Level of Evidence: C) " |
| "4. In patients at high risk for developing heart failure who have known atherosclerotic vascular disease, healthcare providers should follow current guidelines for secondary prevention. (Level of Evidence: C) " |
| Class IIa |
| "1. Angiotensin converting enzyme inhibitors can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: A) " |
| "2. Angiotensin II receptor blockers can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: C) " |
Anemia in Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT)[10][11]
| Class IIb |
| "1.In patients with NYHA class II and III HF and irondeficiency (ferritin <100 ng/mL or 100 to 300 ng/mL if transferrin saturation is <20%), intravenous iron
replacement might be reasonable to improve functional status and quality of life. (Level of Evidence: B-R) " |
| Class III (No Benefit) |
| "1. In patients with HF and anemia, erythropoietin stimulating agents should not be used to improve morbidity and mortality. (Level of Evidence: B-R) " |
Atherosclerotic Disease in Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. In patients at high risk for developing heart failure who have known atherosclerotic vascular disease, healthcare providers should follow current guidelines for secondary prevention. (Level of Evidence: C) " |
| Class IIa |
| "1. Angiotensin converting enzyme inhibitors can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: A) " |
| "2. Angiotensin II receptor blockers can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: C) " |
High Risk Patients (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. Patients at high risk for developing heart failure should be counseled to avoid behaviors that may increase the risk of heart failure (e.g., smoking, excessive alcohol consumption, and illicit drug use). (Level of Evidence: C) " |
| "2. Ventricular rate should be controlled or sinus rhythm restored in patients with supraventricular tachyarrhythmias who are at high risk for developing heart failure. (Level of Evidence: B) " |
| "3. Thyroid disorders should be treated in accordance with contemporary guidelines in patients at high risk for developing heart failure. (Level of Evidence: C) " |
| "4. Healthcare providers should perform periodic evaluation for signs and symptoms of heart failure in patients at high risk for developing heart failure. (Level of Evidence: C) " |
| "5. Healthcare providers should perform a noninvasive evaluation of left ventricular function (i.e., left ventricular ejection fraction) in patients with a strong family history of cardiomyopathy or in those receiving cardiotoxic interventions. (Level of Evidence: C) " |
| Class III (No Benefit) |
| "1. Routine use of nutritional supplements solely to prevent the development of structural heart disease should not be recommended for patients at high risk for developing heart failure. (Level of Evidence: C) " |
Patients at High Risk for Developing Heart Failure (Stage A) (DO NOT EDIT) [3]
| Class I |
| "1. In patients at high risk for developing heart failure, systolic and diastolic hypertension should be controlled in accordance with contemporary guidelines. (Level of Evidence: A) " |
| "2. In patients at high risk for developing heart failure, lipid disorders should be treated in accordance with contemporary guidelines. (Level of Evidence: A) " |
| "3. For patients with diabetes mellitus (who are all at high risk for developing heart failure), blood sugar should be controlled in accordance with contemporary guidelines. (Level of Evidence: C) " |
| "4. Patients at high risk for developing heart failure should be counseled to avoid behaviors that may increase the risk of heart failure (e.g., smoking, excessive alcohol consumption, and illicit drug use). (Level of Evidence: C) " |
| "5. Ventricular rate should be controlled or sinus rhythm restored in patients with supraventricular tachyarrhythmias who are at high risk for developing heart failure. (Level of Evidence: B) " |
| "6. Thyroid disorders should be treated in accordance with contemporary guidelines in patients at high risk for developing heart failure. (Level of Evidence: C) " |
| "7. Healthcare providers should perform periodic evaluation for[signs and symptoms of heart failure in patients at high risk for developing heart failure. (Level of Evidence: C) " |
| "8. In patients at high risk for developing heart failure who have known atherosclerotic vascular disease, healthcare providers should follow current guidelines for secondary prevention. (Level of Evidence: C) " |
| "9. Healthcare providers should perform a noninvasive evaluation of left ventricular function (i.e., left ventricular ejection fraction) in patients with a strong family history of cardiomyopathy or in those receiving cardiotoxic interventions. (Level of Evidence: C) " |
| Class III (No Benefit) |
| "1. Routine use of nutritional supplements solely to prevent the development of structural heart disease should not be recommended for patients at high risk for developing heart failure. (Level of Evidence: C) " |
| Class IIa |
| "1. Angiotensin converting enzyme inhibitors can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: A) " |
| "2. Angiotensin II receptor blockers can be useful to prevent heart failure in patients at high risk for developing heart failure who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors. (Level of Evidence: C)" |
- ↑ Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
- ↑ Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
- ↑ Kostis JB, Davis BR, Cutler J, Grimm RH, Berge KG, Cohen JD; et al. (1997). "Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group". JAMA. 278 (3): 212–6. PMID 9218667.
- ↑ Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ, American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel (2012). "Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): 7S–47S. doi:10.1378/chest.1412S3. PMC 3278060. PMID 22315257.
- ↑ Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D; et al. (2008). "Treatment of hypertension in patients 80 years of age or older". N Engl J Med. 358 (18): 1887–98. doi:10.1056/NEJMoa0801369. PMID 18378519. Review in: Evid Based Med. 2008 Oct;13(5):136 Review in: ACP J Club. 2008 Aug 19;149(2):10 Review in: J Fam Pract. 2008 Aug;57(8):506-7
- ↑ Verdecchia P, Sleight P, Mancia G, Fagard R, Trimarco B, Schmieder RE; et al. (2009). "Effects of telmisartan, ramipril, and their combination on left ventricular hypertrophy in individuals at high vascular risk in the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial and the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease". Circulation. 120 (14): 1380–9. doi:10.1161/CIRCULATIONAHA.109.865774. PMID 19770395.
- ↑ Xie X, Atkins E, Lv J, Bennett A, Neal B, Ninomiya T, Woodward M, MacMahon S, Turnbull F, Hillis GS, Chalmers J, Mant J, Salam A, Rahimi K, Perkovic V, Rodgers A (2016). "Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis". Lancet. 387 (10017): 435–43. doi:10.1016/S0140-6736(15)00805-3. PMID 26559744.
- ↑ Thomopoulos C, Parati G, Zanchetti A (2016). "Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. less intensive blood pressure lowering and different achieved blood pressure levels - updated overview and meta-analyses of randomized trials". J. Hypertens. 34 (4): 613–22. doi:10.1097/HJH.0000000000000881. PMID 26848994.
- ↑ Anker SD, Comin Colet J, Filippatos G, Willenheimer R, Dickstein K, Drexler H, Lüscher TF, Bart B, Banasiak W, Niegowska J, Kirwan BA, Mori C, von Eisenhart Rothe B, Pocock SJ, Poole-Wilson PA, Ponikowski P (2009). "Ferric carboxymaltose in patients with heart failure and iron deficiency". N. Engl. J. Med. 361 (25): 2436–48. doi:10.1056/NEJMoa0908355. PMID 19920054.
- ↑ Ponikowski P, van Veldhuisen DJ, Comin-Colet J, Ertl G, Komajda M, Mareev V, McDonagh T, Parkhomenko A, Tavazzi L, Levesque V, Mori C, Roubert B, Filippatos G, Ruschitzka F, Anker SD (2015). "Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency†". Eur. Heart J. 36 (11): 657–68. doi:10.1093/eurheartj/ehu385. PMC 4359359. PMID 25176939.