Chronic heart failure--optimising care in general practice.
BACKGROUND
Chronic heart failure (CHF) is a significant cause of mortality and morbidity in developed countries where it predominantly affects elderly persons with a range of other comorbid conditions requiring polypharmacy. In Australia, over 300 000 people are affected by CHF. Quality general practice forms the cornerstone for early diagnosis and evidence based integrated care.


OBJECTIVE
This article examines the epidemiology of CHF, its clinical diagnosis, contemporary management and future treatment possibilities, as well as current barriers to optimal care.


CONCLUSIONS
The global prevalence of CHF is rising. Optimal treatment requires a coordinated interdisciplinary approach using a biopsychosocial model of care in order to maximise compliance with therapy. Pharmacological treatment is essential and should include an angiotensin converting enzyme inhibitor and beta blocker where possible. Device based treatment and cardiac surgery may benefit selected cases.
School of Primary Health Care, Monash University, Victoria, Australia. leon.piterman@med.monash.edu.au
Leon
L
Piterman
Hendrik
H
Zimmet
Henry
H
Krum
Andrew
A
Tonkin
Julie
J
Yallop
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D004232:Diuretics / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods; D005194:Family Practice / Q000379:methods*; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000379:methods; D015995:Prevalence
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics