DCRM Multispecialty Recommendations in Patients With Heart Failure

Abstract

Diabetes mellitus (DM), hypertension, obesity, and atherosclerotic cardiovascular disease (ASCVD) are associated with heart failure (HF). Comorbid metabolic conditions in patients with HF are associated with worse outcomes and may affect the management of HF by limiting treatment options and reducing adherence to therapy. 1 Bozkurt B Aguilar D Deswal A Dunbar SB Francis GS Horwich T et al. Contributory risk and management of comorbidities of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement from the. American Heart Association. Circulation. 2016; 134: e535-e578 Google Scholar Practice guidelines for these diseases are drafted by the American Diabetes Association (ADA), the Kidney Disease Improving Global Outcomes (KDIGO) or the American College of Cardiology (ACC)/American Heart Association (AHA). These guidelines are drafted in silos, often without cross-collaboration with other cardiorenal/metabolic specialists. As a result, guidelines commonly differ in their recommendations. For example, the KDIGO guidelines and the ACC/AHA HF guidelines recommend different blood pressure goals for the management of hypertension. 2 Kidney disease: improving global outcomes blood pressure work g: KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021; 99: S1-87 Abstract Full Text Full Text PDF PubMed Scopus (190) Google Scholar ,3 Heidenreich PA Bozkurt B Aguilar D Allen LA Byun JJ Colvin MM et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022; 145: e895-1032 PubMed Google Scholar Comanagement of DM, cardiorenal, and/or metabolic (DCRM) conditions is key to medical optimization. To introduce a more holistic approach to DCRM conditions, a volunteer task force created a multispecialty consensus for the management of complicated comorbid metabolic disease, the DCRM practice recommendations. 4 Handelsman Y Anderson JE Bakris GL Ballantyne CM Beckman JA Bhatt DL et al. DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases. J Diabetes Complicat. 2022; 36108101 Crossref Scopus (4) Google Scholar Herein, we highlight the recommendations of these guidelines for the prevention and management of HF with concurrent DCRM comorbidities.