Treatment patterns among newly diagnosed heart failure patients in general practice

To examine treatment patterns of heart failure (HF) in general practice and to evaluate factors influencing the choice of that treatment, such as age, sex, severity of disease and co-morbidity.

We used previously identified and confirmed incident cases of HF (patients aged 40-84 years) from the General Practice Research Database in the UK (n = 938). We collected recorded information on demographics. co-morbidity and drug treatment prescribed 1 year before and after the incident diagnosis in 1996.

Most of the study cohort was over 60 years old and presented with several concomitant diseases. Use of most cardiovascular drugs significantly increased after the diagnosis of HF. There was a greater than threefold increase in the use of angiotensin-converting enzyme inhibitors, while use of nitrates decreased after diagnosis of HF among men. Use of beta-blockers and calcium channel blockers slightly decreased after diagnosis.

We found that well-established treatment practices were followed by general practitioners. Severity of the disease favoured use of diuretics and a previous ischaemic heart disease and hypertension favoured use of beta-blockers and aspirin. Women and elderly patients were less likely to receive treatment with angiotensin-converting enzyme inhibitors.