RxFiles: Heart Failure

rxfiles.ca/heartfailure

Our guide to the management of heart failure in primary care. 

Heart Failure Drug Comparison Chart

Describes an approach to heart failure therapy, lists lifestyle management tips, and compares heart failure medications including beta-blockers, ACEIs, ARBs, MRAs, sacubitril/valsartan, SGLT2 inhibitors, digoxin, ivabradine, vericiguat, and diuretics. 

Heart Failure Newsletter, November 2020

· Some medications can reduce heart failure mortality: specific beta-blockers, ACEIs, ARBs, MRAs, and SGLT2 inhibitors, as well as sacubitril/valsartan.
· There is no target blood pressure in patients with heart failure.
· Hyperkalemia, hypokalemia, hypotension, bradycardia, and worsening renal function are common in heart failure, but can be managed.
· Diuretics do not change mortality in heart failure and should be regularly reassessed.

The Art of Prescribing in Heart Failure 

Describes approaches to solving common drug therapy problems in heart failure, including: hypotension, bradycardia, hyperkalemia, hypokalemia, worsening renal function, hyponatremia, gout, and dry cough. 

Furosemide Sliding Scale

A tool for escalating and de-escalating furosemide doses in order to achieve euvolemia and allow the up-titration of other heart failure medications. 

BC Heart Failure Zones [external link]

Patient-friendly tool for management of heart failure symptoms. Linked with permission of Cardiac Services BC. 

SADMANS Medications in Heart Failure

Patient handout for teaching when to hold SADMANS medications in heart failure. 

Perspectives on Heart Failure and Diabetes

A guide to comanaging patients with both diabetes and heart failure. 

Heart Failure Landmark Trials

A summary of landmark trial evidence for ACEIs, ARBs, beta-blockers, MRAs, digoxin, and hydralazine & nitrates. Additional landmark trials are below: Emperor-Reduced, SHIFT, DAPA-HF, PARADIGM-HF, and VICTORIA. 

Emperor-Reduced

SHIFT

DAPA-HF

PARADIGM-HF

VICTORIA

Emperor-Preserved

DELIVER

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