Related Experiment Video

Updated: Jun 17, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Changes in adherence to evidence-based medications in the first year after initial hospitalization for heart failure:

Darcy A Lamb1, Dean T Eurich, Finlay A McAlister

  • 1College of Pharmacy & Nutrition and the College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Circulation. Cardiovascular Quality and Outcomes
|December 25, 2009
PubMed

Insights

Medication adherence for heart failure patients has significantly improved over time. Patients taking beta-blockers (BB) or ACE inhibitors/ARBs (ACEI/ARB) showed better adherence in later years.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Evidence-based heart failure medications have seen increased use.
  • Understanding medication adherence trends is crucial for patient outcomes.

Purpose of the Study:

  • To assess changes in medication adherence over a decade.
  • To evaluate adherence to beta-blockers (BB) and ACE inhibitors/angiotensin receptor blockers (ACEI/ARB) in heart failure patients.

Main Methods:

  • Retrospective cohort study using administrative databases (1994-2003).
  • Included patients discharged after their first heart failure hospitalization.
  • Assessed adherence based on pharmacy refill records for BB, ACEI, or ARB prescriptions within 1 year.

Main Results:

  • Optimal adherence (>=80%) at 1 year was 67% for BB and 74% for ACEI/ARB users.
  • Adherence improved significantly over time, with higher rates in 2002/2003 compared to 1994/1995.
  • Patients discharged later were more likely to achieve optimal adherence.

Conclusions:

  • One-year adherence to BB and ACEI/ARB is improving in heart failure patients.
  • Taking multiple cardiac medications did not negatively impact adherence.
  • These findings highlight positive trends in heart failure medication management.
Abstract

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...