Nutrition and heart failure: impact of drug therapies and management strategies.
Nutrition impairment commonly occurs in patients with heart failure and affects disease progression. Vitamin and mineral deficiencies are associated with early mortality, particularly in patients classified as cachectic. Guideline-based therapies approved for heart failure, such as loop diuretics, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, aldosterone antagonists, and beta-adrenergic blockers, can lead to electrolyte abnormalities and predispose to some vitamin and micronutrient deficits. Clinical trial evidence in support of supplementary vitamin and mineral therapies for heart failure patients is limited with the exception of documented calcium and possibly vitamin D, thiamine, and coenzyme Q10 deficiencies. This area is gaining significant attention, and research is ongoing. The clinician can help minimize morbidity from nutrition impairment through appropriate monitoring and correction of baseline and medication-induced electrolyte imbalances, in addition to vitamin and mineral supplementation when appropriate.
Dunn
Steven P
SP
Department of Pharmacy Services, University of Kentucky, 800 Rose Street, Rm H-112B, Lexington, KY 40536-0293, USA. sdunn3@email.uky.edu
Bleske
Barry
B
Dorsch
Michael
M
Macaulay
Tracy
T
Van Tassell
Benjamin
B
Vardeny
Orly
O
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D001361:Avitaminosis / Q000150:complications / Q000188:drug therapy*; D002100:Cachexia / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D000529:Complementary Therapies; D019587:Dietary Supplements; D064420:Drug-Related Side Effects and Adverse Reactions; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D044342:Malnutrition / Q000150:complications / Q000378:metabolism; D009765:Obesity / Q000150:complications; D012084:Renin-Angiotensin System / Q000187:drug effects; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D049994:Sodium Potassium Chloride Symporter Inhibitors