SGLT2 inhibitors in patients with heart failure with preserved ejection fraction

The Activity

The activity includes:

• A short recorded presentation on the latest evidence for the management of Chronic Heart Failure with preserved ejection fraction (from Hot Topics GP Update 2023).
• A review of the latest evidence published on the management of patients with HFpEF.
• A review of three patient records and comparison to the best practice guidelines.
• A reflection on the management and possible changes to practice.

Background

HFpEF is defined as symptoms and signs of heart failure with an EF >50% and echocardiographic features of left atrial enlargement, pulmonary hypertension and impaired diastolic filling.¹ It is most commonly caused by hypertensive heart disease.

Pharmacological management includes diuretics for symptom control and antihypertensives to optimise BP control.² But until recently, no pharmacological interventions have been shown to improve outcomes in patients with HFpEF. However, two recent studies show convincing evidence that SGLT2 inhibitors improve prognosis in patients with HFpEF, irrespective of diabetes status.^3,4

A 2023 review of HFpEF states that ‘first-line pharmacologic therapy consists of SGLT2 inhibitors, such as dapagliflozin or empagliflozin, which reduced heart failure related hospitalisation or  cardiovascular death by approximately 20% compared with placebo in randomised clinical trials.’⁵

Audience

This activity is designed for GPs and GP registrars.