Chronic conditions require ongoing medical attention. This includes heart disease, diabetes, lung disease, and cancer.
There are now three types of left heart failure:
Heart Failure with reduced ejection fraction (HFrEF): LVEF less than or equal to 40%
Heart Failure with mildly reduced ejection fraction (HFmrEF): LVEF of 41% to 49% and evidence of increased LV filling pressures
Heart Failure with preserved ejection fraction (HFpEF): LVEF equal to or greater than 50% and evidence of increased LV filling pressures.
Recommended pharmacological treatment for HFrEF includes four classes of medications, in addition to diuretics:
angiotensin receptor-neprilysin inhibitors or, if not feasible, angiotensin-converting enzyme inhibitors
mineralocorticoid receptor antagonists
There are three types of statin: low-dose, moderate-dose, and high-dose statin.
High-intensity statins are recommended for patients with clinical atherosclerotic disease such as coronary artery disease, peripheral arterial disease, and ischemic stroke or if the patient has diabetes and an ASCVD risk score is more than 7.5%.
Moderate-intensity statins are recommended for patients with diabetes and an ASCVD risk score of less than 7.5%.
Lifestyle changes include:
Exercise for at least 30 minutes a day, most days
Avoid or reduce alcohol use
Reduce salt in your diet
Blood pressure has two measurements:
Systolic pressure is the top number. This is the pressure in the arteries produced when the heart contracts.
Diastolic pressure is the bottom number and refers to the pressure between heartbeats during relaxation.
Common medications started are the following for hypertension:
Angiotensin receptor blockers (Losartan)
Calcium channel blockers (Amlodipine)
Diuretic (Hydrochlorothiazide, Chlorthalidone)