Congestive heart failure: guidelines for the primary care physician.
Heart failure is a common medical condition affecting nearly 5 million people each year in the United States, of whom 500,000 are newly diagnosed. The impact of this disease on society and the health care system is immense. Inpatient and outpatient costs are approximately $40 billion annually, almost $500 million of which is spent on heart failure medications alone. Beyond the problem of financial costs, however, it is imperative for us as health care professionals to improve our ability to prevent disease progression, decrease morbidity and mortality, and optimize patients  quality of life. The use of a broad spectrum of treatments is reviewed in the context of a patient case study. Primary data justifying the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics, digoxin, as well as beta blockers and spironolactone, is reviewed, with special reference to the stage of heart failure.
Galin
Ira
I
Zena and Michael A. Wiener Cardiovascular Institute, Box 1030, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
Baran
David A
DA
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002216:Captopril; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D019808:Losartan; D011320:Primary Health Care; D012307:Risk Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D002216:Captopril; D019808:Losartan