Anzeige
Erschienen in:
01.01.2007 | Original Research Article
Aldosterone Antagonists
The Most Underutilized Class of Heart Failure Medications
Erschienen in: American Journal of Cardiovascular Drugs | Ausgabe 1/2007
Einloggen, um Zugang zu erhaltenAbstract
Background
Aldosterone antagonists have been proven to be beneficial in severe heart failure (HF) as a result of systolic dysfunction. We sought to determine if there is a disparity in their utilization compared with ACE inhibitors and β-adrenoceptor antagonists (β-blockers).
Methods
In the first part of the study, we asked physicians to answer a questionnaire presenting a hypothetical HF patient. In the second part, we reviewed hospital charts of patients with HF exacerbation.
Results
Spironolactone was used less frequently than other drugs. At home, 75.0% of patients were receiving ACE inhibitors, 66.7% received β-blockers, and 38.2% received spironolactone (p < 0.001). During the admission, 93.1% of patients received ACE inhibitors and 58.3% received spironolactone (p < 0.001).
Conclusions
Despite good evidence, underutilization of aldosterone antagonists in patients matching the population of the RALES (Randomized Aldactone Evaluation Study) trial persists in both outpatient and inpatient settings. The difference between the usage of ACE inhibitors and spironolactone is significant in patients with systolic dysfunction equally qualifying for both medications.