Practical issues in the treatment of patients with heart failure

The management of heart failure is complex. Initiating and maintaining drug therapy in patients with heart failure can be challenging. Many factors in fluence the heart failure syndrome and are important to account for when ev aluating these patients. Concomitant diseases such as ischemic heart diseas e and hypertension may contribute to worsening heart failure, and treatment strategies addressing these conditions should be implemented in affected p atients. Concomitant drugs also must be considered. The heart failure popul ation is at risk for drug interactions, both pharmacokinetic and pharmacody namic, because these patients often take many drugs at the same time. Proac tively recognizing potential interactions and modifying a patient's regimen to minimize or avoid adverse effects are important. Many agents are contra indicated in heart failure; thus, avoiding such therapies may significantly affect a patient's outcome. The successful treatment of a patient with hea rt failure requires careful consideration of many factors, including other diseases, drugs, and social issues. Addressing these factors when treating patients translates into improved pharmaceutical care.