title: [Treatment of congestive heart failure].
abstract: The Working Group on Heart Failure of the Norwegian Society of Cardiology here presents a revised programme for the treatment of congestive heart failure. Possible surgical and percutaneous interventions should be considered, and non- pharmacological measures taken as indicated for each patient. ACE-inhibitors are the first-line pharmacological therapy in heart failure with reduced left ventricular ejection fraction (< 40%). Possible adverse effects on blood pressure, renal function and electrolytes necessitate close monitoring of these variables. Beta-blockers should be considered in patients with symptomatic heart failure. If ACE-inhibitors are not tolerated, an angiotensin- II-blocker can be the added. Diuretics should only be used as adjunctive therapy to ACE-inhibitors. Aldosterone antagonists have a proven effect on survival, but close monitoring of potassium levels is imperative. Especially in the elderly, the renal function and level of electrolytes must be monitored closely. Device therapy, such ac cardiac resynchronization therapy and implantable cardioverter defibrillators, are only indicated for selected patients. ACE-inhibitors, diuretics and beta-blockers are the drugs-of-choice for patients with congestive heart failure with preserved systolic function. Health care for patients with congestive heart failure must be well organized on different levels of care and with multidisciplinary teams involved. The goal is to reduce morbidity and mortality in the heart failure population. This programme is meant for primary, secondary and third line health care providers in Norway.
authors.affiliation: Hjertemedisinsk avdeling, Rikshospitalet, 0027 Oslo. marit.aarones@rikshospitalet.no
authors.forename: Marit
authors.initials: M
authors.lastname: Aarønaes
authors.forename: Dan
authors.initials: D
authors.lastname: Atar
authors.forename: Vernon
authors.initials: V
authors.lastname: Bonarjee
authors.forename: Torstein
authors.initials: T
authors.lastname: Gundersen
authors.forename: Maja-Lisa
authors.initials: ML
authors.lastname: Løchen
authors.forename: Rune
authors.initials: R
authors.lastname: Mo
authors.forename: Eivind S P
authors.initials: ES
authors.lastname: Myhre
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Omland
authors.forename: Per K
authors.initials: PK
authors.lastname: Rønnevik
authors.forename: Johnny
authors.initials: J
authors.lastname: Vegsundvåg
authors.forename: Arne
authors.initials: A
authors.lastname: Westheim
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D004232:Diuretics / Q000008:administration & dosage; D006333:Heart Failure / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010347:Patient Care Planning / Q000458:organization & administration
chemical_list: D000318:Adrenergic beta-Agonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics