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Outpatient Medication Titration in Acute Heart Failure

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Short Stay Management of Acute Heart Failure

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Outpatient management of heart failure has changed significantly over the past 20 years, with evolving concepts of what improves longevity, decreases hospitalizations, and improves functional capacity. Randomized controlled trials have established the efficacy of many medications in reducing morbidity and mortality in patients with heart failure: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers (carvedilol, metoprolol succinate, and bisoprolol), aldosterone antagonists, sodium channel blockers, and neprilysin inhibitors. Despite these therapeutic options, patients are frequently undertreated, and appropriate medications are not titrated to evidence-based doses. A stepwise approach to initiation of heart failure medication and titration to therapeutic doses is recommended and can be guided by considering both the American College of Cardiology/American Heart Association (ACC/AHA) class and New York Heart Association (NYHA) functional class of the patient. Such an approach is outlined in this chapter.

Chapter updated from prior edition which was authored by Khadijah Breathett MD and L. Kristin Newby MD MHS

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, 32610, USA

    Juan R. Vilaro MD & David E. Winchester MD, MS

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  1. Juan R. Vilaro MD
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  2. David E. Winchester MD, MS
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Correspondence to David E. Winchester MD, MS .

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  1. Department of Emergency Medicine, Baylor College of Medicine, HOUSTON, Texas, USA

    W. Frank Peacock

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Vilaro, J.R., Winchester, D.E. (2017). Outpatient Medication Titration in Acute Heart Failure. In: Peacock, W. (eds) Short Stay Management of Acute Heart Failure. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-44006-4_19

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  • DOI: https://doi.org/10.1007/978-3-319-44006-4_19

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