References

Blue L, Lang E, McMurray JJV Randomised controlled trial of specialist nurse intervention in heart failure. BMJ.. 2001; 323:(7315)715-8 https://doi.org/10.1136/bmj.323.7315.715

Number of GP practices in England falls by 263 in 12 months. 2018. www.gponline.com/number-gp-practices-england-falls-263-12-months/article/1487848 (accessed 11 July 2019)

Burnett H, Earley A, Voors AA Thirty years of evidence on the efficacy of drug treatments for chronic heart failure with reduced ejection fraction: a network meta-analysis. Circ Heart Fail. 2017; 10:(1)1-12 https://doi.org/10.1161/CIRCHEARTFAILURE.116.003529

Entresto 24/26mg filmed coated tablets. 2018. https://www.medicines.org.uk/emc/product/7751/smpc (accessed 11 July 2019)

Forsyth P, Lowrie R, Jhund PS High burden of primary care contacts in patients with left ventricular systolic dysfunction-findings from the heart failure and optimal outcomes from pharmacy study. Euro Heart J.. 2015; 36:(1)163-508 https://doi.org/10.1093/eurheartj/ehv399

Jhund PS, Macintyre K, Simpson CR Long-term trend in the first hospitalisation for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation. 2009; 119:(4)515-523 https://doi.org/10.1161/CIRCULATIONAHA.108.812172

Konstam MA, Neaton JD, Dickstein K Effects of high-dose versus low dose losartan on clinical outcomes in patients with heart failure (HEAAL study): arandomised, double-blind trial. Lancet. 2009; 37:(9704)1840-48 https://doi.org/10.1016/S0140-6736(09)61913-9

Kotecha D, Flather MD, Altman DG Heart rate, heart rhythm and prognostic benefits of beta-blockers in heart failure: individual patient-data meta-analysis. Journal of the Am J Cardiol.. 2017; 64:(24)2885-2896 https://doi.org/10.1016/j.jacc.2017.04.001

Lopatin Y. Heart failure with mid-range ejection fraction and how to treat it. Card Fail Rev.. 2018; 4:(1)9-13 https://doi.org/10.15420/cfr.2018:10:1

McMurray JJV, Packer M, Desai AS Angiotensin–Neprilysin Inhibition versus Enalapril in heart failure. New Engl J Med.. 2014; 371:(11)993-1004 https://doi.org/10.1056/NEJMoa1409077

National Cardiac Audit Programme National Heart Failure Audit 2016/17 summary report. 2018. https://www.nicor.org.uk/wp-content/uploads/2018/11/Heart-Failure-Summary-Report-2016-17.pdf (Accessed 9 June 2019)

Chronic heart failure in adults: diagnosis and management. 2018. https://www.nice.org.uk/guidance/ng106 (accessed 11 July 2019)

Okumura N, Jhund PS, Gong J Importance of clinical worsening of heart failure treated in the outpatient setting evidence from the prospective comparison of arni with acei to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-heart failure). Circulation. 2016; 133:(23)2254-62 https://doi.org/10.1161/CIRCULATIONAHA.115.020729

Packer M, Poole-Wilson PA, Armstrong PW Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. Circulation. 1999; 100:(23)2312-18 https://doi.org/10.1161/01.cir.100.23.2312

Ponikowski P, Voors AA, Anker SD 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J.. 2016; 37:(27)2129-200 https://doi.org/10.1002/ejheartfailure.592

Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. European Heart Journal. 2018; 39:(34)3165-241 https://doi.org/10.5603/KP.2019.0049

SIGN 147 Management of chronic heart failure: a national clinical guideline. 2016. https://www.sign.ac.uk/assets/sign147.pdf (accessed 11 July 2019)

Cardiovascular health

Opportunities for practice nurses when managing heart failure

02 September 2019
Clinical Focus
02 September 2019
Volume 30 · Issue 9

Abstract

As the UK's population ages and the prevalence of heart failure rises, practice nurses need to be aware of how they can contribute to management and treatment. Lynsey Moir explains the symptoms of heart failure and indicates opportunities for nurses to boost patient care

Heart failure is a complex clinical syndrome with a prevalence of 1–2% in the UK. Heart failure places a significant demand on NHS resources and this is expected to increase as both the incidence and prevalence rise. Practice nurses have a vital role to play in the delivery of care to patients with heart failure, from diagnosis to providing long-term condition reviews and through to end-of-life care. Collaborative working with the heart failure multidisciplinary team can bring new opportunities for practice nurses, ensure sustainability of heart failure services, enhance care and improve outcomes for patients.

Heart failure is a complex clinical syndrome characterised by signs and symptoms caused by structural or functional abnormalities of the heart (National Institute for Health and Clinical Excellence (NICE), 2018). Typical symptoms include breathlessness, ankle swelling and fatigue. Signs of fluid overload such as elevated jugular venous pressure, peripheral oedema and pulmonary crackles on auscultation may be present (Ponikowski et al, 2016). Ischaemic heart disease and previous myocardial infarction are the leading causes of heart failure in the UK (National Institute for Cardiovascular Outcomes Research (NICOR, 2018).

The prevalence of heart failure is approximately 1–2% and increases steeply with age (NICE, 2018), reaching more than 10% in those over 70 years of age (Ponikowski et al, 2016). Heart failure accounts for 1 million bed days per year and approximately 2% of the NHS total spend (NICOR, 2018).

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Cardiovascular
Heart failure
Primary care
Practice nursing
Multidisciplinary team