NICE is in the process of updating its clinical guideline on the management of chronic heart failure in adults and has today (14 January) published its draft recommendations for public consultation.Since the original guideline was published in 2003, new high-quality evidence from randomised controlled trials in diagnosis, treatment and monitoring have been published. This partial update will ensure that the recommendations take into account the new evidence available.
Heart failure is a complex clinical syndrome of symptoms and signs such as breathlessness, fatigue and fluid retention that suggest the efficiency of the heart is impaired. The most common cause of heart failure in the UK is coronary artery disease, with many patients having suffered a myocardial infarction (heart attack) in the past. The draft recommendations cover the diagnosis and treatment of heart failure, including defining the combination of symptoms, signs and investigations which together are most effective in confirming a diagnosis of heart failure and influencing subsequent optimum treatments.
Dr Fergus Macbeth, Director, Centre for Clinical Practice at NICE said: “The prevalence of heart failure is expected to rise in the future as more people live longer generally, people survive longer with coronary artery disease and there are better treatments for heart failure. Currently some 900,000 people in the UK have had a diagnosis of heart failure, with almost as many again who may have damaged hearts but as yet no symptoms. It’s clearly very important that clinicians working in this area have a guideline that is based on the most up-to-date evidence of what works best. This new draft guideline outlines a comprehensive approach to the management of heart failure, and ultimately seeks to improve the length and quality of life of people with the condition.
Dr Macbeth continued:“The draft guideline clearly indicates those recommendations that are new or have been changed from the original. For example, the original guideline recommended the use of echocardiography to help confirm a diagnosis of heart failure only after other tests were inconclusive. However, based on a review of new evidence about the best way for primary care physicians to diagnose heart failure published since the original NICE guideline, the updated draft recommends that people with suspected heart failure and who have had a previous heart attack should be referred urgently for echocardiography and specialist assessment.”
The draft recommendations are available on the NICE website at: http://www.nice.org.uk/guidance/index.jsp?action=folder&o=46793. Anyone wishing to submit comments on the draft guidance is invited to do so via the NICE website between 14 January and 10 March.