Author + information
- Received November 20, 2013
- Revision received March 25, 2014
- Accepted April 3, 2014
- Published online October 1, 2014.
- Graham D. Cole, MB, BChir, MA∗ (, )
- Sheetal J. Patel, MBBS, BSc,
- Nabeela Zaman, MBBS, BSc,
- Anthony J. Barron, MBBS,
- Claire E. Raphael, MA, BSc,
- Jamil Mayet, MB, ChB, MD, MBA and
- Darrel P. Francis, MA
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Graham Cole, International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, 59-61 North Wharf Road, London W2 1LA, United Kingdom.
Prescription and adherence to medical therapy for heart failure are disappointing despite convincing randomized controlled trial (RCT) evidence for angiotensin-converting enzyme inhibition, beta-blockade, and aldosterone antagonism. In this study, we report an imbalanced approach amongst clinicians, who describe focusing during patient consultations on perceived risks of therapy rather than survival benefits. Only one-half of clinicians mention increased lifespan, and very few suggest to the patient how large this gain might be. We calculate from the available RCT data that, for patients whose lifespan is limited by heart failure, triple therapy triples lifespan.
- aldosterone antagonists
- angiotensin-converting enzyme inhibitors
- heart failure
- life expectancy
Dr. Cole (grant FS/12/12/29294), Dr. Barron (grant PG/11/36/28883), and Prof. Francis (grant FS/010/038) are funded by the British Heart Foundation.
- Received November 20, 2013.
- Revision received March 25, 2014.
- Accepted April 3, 2014.
- American College of Cardiology Foundation