Dose Up-Titration Of Neurohormone Blockers For Chronic Heart Failure Treatment In Real Clinical Practice: Data From Single University Centre

Abstract

Objective. To describe treatment peculiarities of ambulatory chronic heart failure patients’ in one of Lithuania’s university centres, participating in European Society of Cardiology EURObservation Research Programme (EORP) Heart Failure Long- Term Registry. Methods. 240 ambulatory patients with chronic heart failure were entered in European Society of Cardiology EURObservation Research Programme (EORP) Heart Failure Long-Term Registry from our university centre between May 2011 and March 2013. Follow-up data were collected after 12 months. Registered data about heart failure treatment were included to this study. Statistical analysis was performed with SPSS 22 program. Results. In our centre 67,1% of patients received angiotensin converting enzyme inhibitors at target doses, one third (34,3%) had not reached target doses due to symptomatic hypotension. Beta blockers were up-titrated to target doses for 82,5% of patients and the main reasons for failure to reach their target dose were: symptomatic bradycardia (12,7%), symptomatic hypotension (10,7%). Mineralocorticoid receptor antagonists were up-titrated to a target doses just for half of the patients – 52,1% and the most frequent reason for not reaching target doses was hyperkalemia (15,4%). Conclusions. Angiotensin converting enzyme inhibitors, beta-blockers and mineralocorticoid receptors antagonists, except angiotensin receptor blockers, were prescribed in a guideline-recommended doses. The main reasons why the target doses of neurohormone blockers have not been achieved were symptomatic hypotension for angiotensin converting enzyme inhibitors, symptomatic bradycardia for beta-blockers and hyperkalemia for mineralocorticoid receptors antagonists.