Treatment Nonpharmacologic Interventions 1-Dietary modifications in HF consist of sodium restriction, and sometimes fluid restriction (5). 2-Exercise is recommended when patients are stable (5). 3-Modification such as and (5). of classic risk factors, tobacco alcohol Pharmacologic Treatment A-Systolic Heart Failure Agents with proven benefits in improving symptoms, and improving survival (reduce mortality) in chronic HF include ACE inhibitors, and ARBs, blockers (1), aldosterone antagonists in select β-adrenergic patients (1, 5). Figure 2: treatment algorithm for HF (1). 1-Angiotensin-Converting Enzyme(ACE) Inhibitors ACE inhibitors should be prescribed to all patients with systolic HF. In general, ACE inhibitors are used together with (9). ACE β-blockers inhibitors should be initiated at low doses, followed by increments in dose if lower doses have been well tolerated (10). 2-β-Blockers 1-β-blockers should be prescribed to all patients with stable systolic HF. Extended-release metoprolol, carvedilol, and bisoprolol are FDA approved for use in HF (9). 2- should be initiated in stable patients who have no or β-Blockers minimal evidence of fluid overload (1). should be started in β-blockers very low doses with slow dose titration (1) (start low, go slow) (14) to avoid symptomatic worsening (1). 3-Diuretics Diuretic therapy is recommended in all patients with clinical evidence of retention (1, 11). Loop diuretics are the most widely used (5). diuretics in HF 4-Aldosterone Antagonists
Treatment Nonpharmacologic Interventions 1-Dietary modifications in HF consist of sodium restriction, and sometimes fluid restriction (5). 2-Exercise is recommended when patients are stable (5). 3-Modification of classic risk factors, such as tobacco and alcohol (5). Pharmacologic Treatment A-Systolic Heart Failure Agents with proven benefits in improving symptoms, and improving survival (reduce mortality) in chronic HF include ACE inhibitors, ARBs, β-adrenergic blockers (1), and aldosterone antagonists in select patients (1, 5). Figure 2: treatment algorithm for HF (1). 1-Angiotensin-Converting Enzyme(ACE) Inhibitors ACE inhibitors should be prescribed to all patients with systolic HF. In general, ACE inhibitors are used together with β-blockers (9). ACE inhibitors should be initiated at low doses, followed by increments in dose if lower doses have been well tolerated (10). 2-β-Blockers 1-β-blockers should be prescribed to all patients with stable systolic HF. Extended-release metoprolol, carvedilol, and bisoprolol are FDA approved for use in HF (9). 2- β-Blockers should be initiated in stable patients who have no or minimal evidence of fluid overload (1). β-blockers should be started in very low doses with slow dose titration (1) (start low, go slow) (14) to avoid symptomatic worsening (1). 3-Diuretics Diuretic therapy is recommended in all patients with clinical evidence of retention (1, 11). Loop diuretics are the most widely used diuretics in HF (5). 4-Aldosterone Antagonists
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