Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB)
According to the Agency for Healthcare Research and Quality (AHRQ): Routine lifelong use of angiotensin converting enzyme (ACE) inhibitors (or angiotensin receptor blockers) is recommended for heart failure patients with a lower than normal ejection fraction (40 percent or less).
Yet, a new study shows that nearly half of heart failure patients were not prescribed ACE inhibitors upon hospital discharge and almost one-third of those who were discharged with ACE inhibitors had stopped taking them within a year. Considering that almost 50 percent of heart failure patients are readmitted to the hospital within 6 months of discharge, underuse of ACE inhibitors is a significant problem (Journal of the American College of Cardiology, June 2, 2004: 43(11); 2036-2043).
Unless otherwise contraindicated, the protocol at UAMS Medical Center includes prescribing an angiotensin converting enzyme inhibitor or angiotensin receptor blocker medication for patients with heart failure at discharge.
The most recent report (4th qtr., 2010) shows 100% percent of UAMS patients with heart failure received a discharge prescription for an angiotensin converting enzyme inhibitor or angiotensin receptor blocker medication unless otherwise contraindicated compared with the national average 90% and the average for University Healthsystem Consortium of 96%.