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ACE inhibitors are under prescribed in heart failure patients
Quality Improvement Monitor, September 17, 2004
About 32% of elderly heart failure patients are discharged from hospitals without prescriptions for angiotensin-converting enzyme (ACE) inhibitors, leaving them vulnerable to an increased risk of death, according to new research.
Twenty years of evidence overwhelmingly shows how ACE inhibitors can benefit heart failure patients. In fact, patients discharged without anti-angiotensin therapy have a 14% percent greater risk of dying within a year compared to patients treated with ACE inhibitors.
"The under-use of life-saving medications in patients with systolic heart failure is a pervasive problem throughout the healthcare community," says Frederick Masoudi, MD, MSPH, lead author of the study and assistant professor of medicine at Denver Health Center and the University of Colorado Health Sciences Center in Denver.
Several factors may explain why ACE inhibitors are under-used in heart failure patients. Physicians may either lack awareness about the potential benefits of ACE inhibitor or may be reluctant to prescribe them in certain high-risk patients, Masoudi says.
In addition, some healthcare delivery systems might lack the necessary structure, controls, or resources to ensure that heart failure patients receive such evidence-based care.
Masoudi's research appears in the August 3 issue of Circulation: Journal of the American Heart Association.
-- Wendy Johnson
wjohnson@hcpro.com
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