Heart Failure Therapy in the Actual World: A Proposal of Monitoring and Application of Recommended Therapies

pp 441-448

Abstract

The heart failure(HF),is a syndrome of huge epidemiological importance in terms of incidence/prevalence, morbidity/mortality and expenses generated to the Public Health. Well outlined randomized clinical trials (RCT) had shown the efficacy of the beta blockers (BB) and the angiotensin converting-enzyme (ACE) inhibitors in the treatment of this entity. On the other hand, observational studies had demonstrated that in different places of the clinical practice, the benefits of RCT are not always translated to the patients (less than the 50% of theHF patients receive these drugs in outpatients).   This difficulty of transferability of evidences be-comes a challenge that we have not to underestimate. Patients with HF are highly selected in clinical trials and are different from those in the community; that's why the physicians would not make generalizations about the results to the subgroups that are out of the RCT. The development of "population trials" and observational studies is based on collaborative networks as a methodology to introduce efficacious therapies, and to obtain another pharmacoepidemiological information necessary to provide the best care to our patients (illustrated by the BRING UP Study). It emerges as an attractive answer to diminish the impact of the above-mentioned problem. We show here the HF condition and a proposal of collaborative work involving some medical institutions in Argentina and of settling monitoring programs of this and another epidemiological matters, largely unexplored.