In 2001 the Heart Failure Society of America, with support from the U.S. Senate and the Society President, Arthur M. Feldman MD, declared the week of Valentine’s Day as National Heart Failure Awareness Week! Today, this week is celebrated in the United States and Europe.
Fast forward to 2021-- Heart Failure Awareness Week is upon us (February 14-20, see below for highlights). This is a perfect opportunity for all members - healthcare professionals and patients, to promote prevention of heart failure and healthier living with heart failure (for example, raising awareness of the value of physical activity and exercise) and to discuss implementation of management strategies that may promote improved quality of life and less morbidity and mortality (for example, regular visits to providers to facilitate objective assessment and evaluation of current status, collaboration between providers of care so that everyone understands the goals of treatment, and prescription/treatment recommendations for optimal medication therapies and cardiac devices or surgeries, when needed).
Why should we all care? In the American Heart Association Heart & Stroke Statistics-2021 Update, mortality continues to be high and vary among states. In addition, the number of cases with heart failure mentioned on death certificates (any-mention) increased over time. Hospitalizations of cases with a principal diagnosis of heart failure have decreased over time to 809,000 but prevalence, incidence and costs of care remain high (1). The burden of living with heart failure is due to multiple factors that involve patients, providers, clinicians, healthcare centers and communities. The complexity of managing heart failure has increased in recent years as have gaps in care management (in other words, failure in consistently following national guideline recommendations). In 2021, a consensus decision pathway was developed to help healthcare professionals understand how to adapt the guidelines when managing heart failure (2).
The question is, how aware are you of 2021 consensus recommendations in patients with heart failure with reduced ejection fraction and symptoms (2)? If you are unaware of or have an alternate perception of 1 or more of the bullets listed below, the week of February 14 is the perfect time to increase your awareness of heart failure treatment expectations!
In patients with heart failure with reduced ejection fraction and symptoms…
- When initiating an agent in the renin-angiotensin blocker therapy family, an angiotensin receptor-neprilysin inhibitor is preferred.
- In multiple research studies of sacubitril-valsartan (an angiotensin receptor-neprilysin inhibitor), use was not associated with worsening renal function.
- After initiating an angiotensin receptor-neprilysin inhibitor, angiotensin converting enzyme inhibitor, or angiotensin receptor antagonist, an evidence-based beta-blocker and hydralazine plus nitrate therapies, up-titration should occur every 2 weeks until maximum tolerated or target doses are achieved.
- A sodium-glucose cotransporter 2 agent is recommended if the ejection fraction is at or below 40% with or without diabetes in conjunction with guideline directed medical therapies for heart failure.
- The I-NEED-HELP mnemonic is a great aid in recognizing clinical clues of advanced heart failure. When present, consultation with a heart failure specialty cardiologist/team or discussions of palliative care are warranted.
Highlights for Heart Failure Awareness Week
There are many ways you can still get involved in Heart Failure Awareness Week – including simply sharing the information about the campaign with your patients.
A special thanks to:
- Members like you who submitted topics and wrote posts for the Innovations Countdown
- Patient Committee members for helping to develop Twitter Chat questions and answers
- Communications Committee members for creating podcast episodes, vetting toipcs and refining posts for the Innovations Countdown, and helping to develop Twitter Chat questions and answers
- Heart Failure Awareness Week Organizational Partners
- Heart Failure Awareness campaign Supporters
Nancy M. Albert, PhD, CCNS, FHFSA
HFSA President 2020-2021