Heart Podcast
Sequencing of medical therapy in heart failure with a reduced ejection fraction
Aug 29, 2023
Dr. Henry Savage discusses the sequencing of medications for heart failure with reduced ejection fraction. The podcast explores the four pillars of therapy, challenges in achieving optimal doses, and the use of low doses of multiple medications. It also highlights the importance of educating patients about diuretics, having conversations after 12 weeks of therapy, and implementing a heart failure team approach.
22:32
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Quick takeaways
- Optimizing medication doses in heart failure with reduced ejection fraction (HFrEF) requires a patient-centered approach starting with a beta blocker and an SGLT2 inhibitor, followed by an ACE inhibitor or ARB for patients with stable blood pressure.
- Non-optimized dosing of HFrEF medications can lead to missed opportunities for better outcomes, highlighting the importance of proactive titration of medications for each patient in order to achieve optimal doses.
Deep dives
Introduction to Heart Failure with Reduced Ejection Fraction
Heart failure with reduced ejection fraction (HFrEF) refers to patients whose heart doesn't pump effectively, typically less than 50%. In the past, mortality rates were high for HFrEF patients, but breakthroughs in drug therapy, such as ACE inhibitors, beta blockers, and sacubitril/valsartan, have significantly improved outcomes. Additionally, SGLT2 inhibitors have shown benefits in HFrEF patients. These drugs form the foundation of HFrEF treatment.
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