AFP: American Family Physician Podcast Episode 235 - August 2025 - Part 1 AFP: American Family Physician
Aug 19, 2025
Discover the latest insights on heart failure with reduced ejection fraction and innovative therapies that may revolutionize treatment. Dive into the complexities of managing venous leg ulcers, balancing therapeutic pressure with patient comfort. Explore personalized approaches to chronic pain management that highlight the importance of tailored treatments. Finally, get informed on resuscitation strategies and monitoring practices, along with guidelines for managing low-risk breast ductal carcinoma in situ.
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Start And Titrate Heart Failure GDMT Quickly
- Start goal-directed medical therapy (GDMT) promptly and aim to titrate all four pillars within six to 12 weeks.
- Prioritize beta blocker and SGLT2 inhibitor early, then add a RAS inhibitor and MRA within weeks.
Massive Mortality Benefit From Full GDMT
- Combining all four GDMT classes reduces all-cause mortality by 61% compared with placebo.
- For a 50-year-old, this equates to about 7.9 additional years of life.
Manage GDMT Side Effects Without Overreacting
- Monitor for hypotension and hyperkalemia but do not stop GDMT for asymptomatic systolic BP >90 mm Hg.
- Stop MRAs if potassium >6 mEq/L and consider SGLT2s to mitigate hyperkalemia.