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European Journal of Heart Failure 2001 3(4):495-502; doi:10.1016/S1388-9842(01)00173-8
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© 2001 European Society of Cardiology

Practical recommendations for the use of ACE inhibitors, beta-blockers and spironolactone in heart failure: putting guidelines into practice

John McMurraya,*, Alain Cohen-Solalb, Rainer Dietzc, Eric Eichhornd, Leif Erhardte, Richard Hobbsf, Aldo Maggionig, Ileana Pinah, Jordi Soler-Soleri and Karl Swedbergj

a Clinical Research Initiative in Heart Failure Glasgow, Scotland G11 6NT, UK
b L'Hôpital Beaujon Clichy, France
c Franz-Volhard-Klinik Berlin, Germany
d VA Hospital Dallas, TX, USA
e University Hosptial Malmo, Sweden
f Department of Primary Care and General Practice Birmingham, UK
g Research Centre Anmco Florence, Italy
h University Hospital Cleveland, USA
i Vall d'Hebron University Barcelona, Spain
j Department of Medicine, Sahlgrenska Hospital/Östra Goteborg, Sweden

* Corresponding author. Tel.: +44-141-330-6588; fax: +44-141-330-6588. E-mail address: j.mcmurray{at}bio.gla.ac.uk (J. McMurray).


   Abstract

Surveys of prescribing in both hospitals and primary care have shown delays in translating improved survival data from clinical trials into clinical practice thereby denying patients the benefits of proven treatments, such as the angiotensin converting enzyme inhibitors. This may be due to unfamiliarity with clinical guidelines and concerns about adverse events. Recent trials have shown that substantial improvements in survival are associated with spironolactone and beta-blocker therapy. In order to accelerate the uptake of these treatments, and to ensure that all eligible patients should receive the most appropriate medications, a clear and concise set of clinical recommendations has been prepared by a group of clinicians with practical expertise in the management of heart failure. The objective of these recommendations is to provide practical guidance for non-specialists in order to support the implementation of evidenced-based therapy for heart failure. These practical recommendations are meant to supplement rather than replace existing guidelines.

Key Words: Clinical recommendations • Beta-blockers • Angiotensin converting enzyme inhibitors • Spironolactone • Heart failure

Received June 1, 2001; Accepted June 25, 2001


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