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November 2020

Study shows gaps in care for HFpEF patients



People with heart failure with preserved ejection fraction (HFpEF) often struggle to get a diagnosis and access care, and treatment options are limited, according to a recent study in the British Journal of General Practice.

HFpEF affects about half of patients with heart failure, but frequently goes undiagnosed.

Symptoms include shortness of breath, oedema and extreme fatigue. It is more common in older people with a history of hypertension, obesity and diabetes.

Lead author, Dr Emma Sowden, of the University of Manchester said: ‘Our research paints a picture of clinical uncertainty surrounding the diagnosis and treatment of HFpEF, which often leads to failure to manage the condition.’ Patients often faced a ‘protracted series of hospital admissions or specialist visits’ in their quest for a diagnosis.

Co-author Professor Christi Deaton added: ‘We heard some clinicians asking “what’s the point of diagnosis if there is no specific treatment?” But identification of HFpEF is critical if we are going to develop new treatments and ways for patients to better manage their condition.’

NEW TREATMENT FOR HFrEF

The European Commission has approved the SGLT2 inhibitor dapagliflozin as a new treatment for heart failure with reduced ejection fraction (HFrEF) in patients with or without type 2 diabetes.

Approval was based on positive results from the landmark DAPA-HF landmark trial, which showed that compared with placebo, dapagliflozin reduced cardiovascular death or worsening of HF.

Dapagliflozin is the first SGLT2 inhibitor to be licensed for HF, which affects almost a million patients in the UK, with mortality risk worse than some of the most common cancers. It is the leading cause of hospitalisation in patients over the age of 65.

Practice Nurse 2020;50(9):8