Lack of Improvement in Outpatient Management of Congestive Heart Failure in the United States

Abstract

Congestive heart failure (CHF) continues to account for 3% of admissions to hospitals in the United States, and the diagnosis carries a mortality rate of 20% at one year and 80% at eight years.1,2 There have been numerous advances in the chronic medical management of CHF, including angiotensin antagonists, beta blockers, and aldosterone antagonists, all of which have shown significant mortality reductions in clinical trial populations with varying degrees of CHF severity.2–4 Evidence from clinical trials, however, does not always readily translate to community practice.5,6 Previous studies in outpatient populations in the late 1990s and the early 2000s observed suboptimal use of evidence-based therapy for CHF. Using nationally representative data, we evaluated whether patterns of medication use have improved over time.