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Foundations of Pharmacotherapy for Heart Failure With Reduced Ejection Fraction

Evidence Meets Practice, Part I

Paul, Sara DNP, FNP, FAHA, CHFN; Page, Robert L. II PharmD, MSPH, FAHA, BCPS

Journal of Cardiovascular Nursing: March/April 2016 - Volume 31 - Issue 2 - p 101–113
doi: 10.1097/JCN.0000000000000284
DEPARTMENTS: Pharmacology: Evidence Meets Practice

Pharmacologic treatment for systolic heart failure, otherwise known as heart failure with reduced ejection fraction, has been established through clinical trials and is formulated into guidelines to standardize the diagnosis and treatment. The premise of pharmacologic therapy in heart failure with reduced ejection fraction is aimed primarily at interrupting the neurohormonal cascade that is responsible for altering left ventricular shape and function. This is the first in a series of articles to describe the pharmacologic agents in the guidelines that impact the morbidity and mortality associated with heart failure. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and vasodilators will be presented in the context of the mechanism of action in heart failure, investigational trials that showed beneficial effects, and the practical application for clinical use.

Sara Paul DNP, FNP, FAHA, CHFN Director, Heart Function Program, Catawba Valley Cardiology, Conover, North Carolina.

Robert L. Page II, PharmD, MSPH, FAHA, BCPS Professor, Clinical Specialist, Division of Cardiology, School of Pharmacy and Medicine, University of Colorado Skaggs, Aurora.

The authors have no funding or conflicts of interest to disclose.

Correspondence Sara Paul, DNP, FNP, FAHA, CHFN, Heart Function Program, Catawba Valley Cardiology, 3521 Graystone Place SE, Ste 202, Conover, NC 28613 (

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