Getting to the Heart of the Patient Interview: A Focus on Heart Failure (Part II)

A thorough and accurate patient assessment is critical to managing patients with heart failure. In this second post of our two-part series, we’ll focus on volume status and adherence to medications and dietary recommendations. Check out our first post for general principles and an assessment of functional status. A template collection tool is also provided.

Getting to the Heart of the Patient Interview: A Focus on Heart Failure (Part I)

A thorough and accurate patient assessment is critical to managing patients with heart failure. In this two-part series, we’ll provide an overview of the key components of assessing patients with heart failure, starting first with general principles and an evaluation of functional status. Our second piece will focus on volume status and adherence to medications and dietary recommendations. A template collection tool is also provided.

Titration of Renin-Angiotensin System Inhibitors in Patients with Heart Failure with Reduced Ejection Fraction and an “At-Goal” Blood Pressure

Initiation and titration of guideline-directed medical therapy is paramount for patients with heart failure with reduced ejection fraction (HFrEF), as it reduces the risk of death and other complications. Despite this, many patients do not receive the appropriate therapies or doses due to concerns and/or misconceptions about the use of these therapies. One reason often cited for not using or titrating inhibitors of the renin-angiotensin system is that blood pressure is already “at goal” or is “too low”. In this blog, the data surrounding titration of angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and the angiotensin II receptor blocker/neprilysin inhibitor in patients with HFrEF will be addressed.

Hemoglobin A1c Goals in Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease

Treatment of diabetes is associated with a reduction in both macro- and microvascular complications. Macrovascular complications include myocardial infarction and stroke. One of the goals of therapy for patients with type 2 diabetes mellitus is a reduction in hemoglobin A1c (HbA1c). The goal or target HgbA1c is individualized for patients based on the presence of comorbidities, among other factors. Cardiovascular disease (CVD), when present, may influence an individual’s HbA1c goal. This blog will review the data surrounding the HbA1c goal in those with type II diabetes and established CVD.

Treat the Patient, Not the Number: Stroke Prevention in Atrial Fibrillation with Low CHA2DS2-VASc Scores

Although guidelines for the management of atrial fibrillation advocate for anticoagulation in patients with a high stroke risk (CHA2DS2-VASc score of 2 or greater), the recommendations for patients at low (CHA2DS2-VASc 0) and in particular intermediate (CHA2DS2-VASc 1) risk of stroke are less clear. In this blog, we discuss antithrombotic strategies in these latter two subgroups.