CPD

• Echocardiography is the cornerstone of heart failure (HF) diagnosis and classifies HF into HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). This determines pharmacological treatment.
• Patients with HF can be managed by GPs as part of a multidisciplinary HF team; this model of care reduces hospital readmissions and may reduce mortality.
• Consider four medication classes for patients with HFrEF; renin-angiotensin system inhibitors (angiotensin receptor-neprilysin inhibitor preferred), beta blockers, mineralocorticoid receptor antagonist and sodium glucose cotransporter inhibitors. Initiate therapy with at least two classes, simultaneously, at low dose. Do not start a beta blocker if the patient is fluid overloaded.

Keeping LDL-C levels lower throughout life can help substantially reduce CVD risk.¹ GPs play an essential role in identifying patients at risk of CVD and managing their treatment.² This includes prescribing lipid-lowering medicines for people at high risk of CVD.³ Although for most patients, elevated lipids can be assessed and managed effectively by GPs, there are some groups of patients who may benefit from referral to a specialist.⁴ These include patients whose total cholesterol is more than 7.5mmol/L, patients who fail to show an effective response to second-line treatment and those with familial hypercholesterolaemia.⁴