The main groups of drugs used to treat heart failure are Angiotensin Converting Enzyme (ACE) inhibitors, Beta-adrenoceptor blocking drugs (beta-blockers) and diuretics.

Results from randomised control trials in the USA and Scandinavia in patients with heart failure due to left ventricular systolic dysfunction, have shown that ACE inhibitors and beta blockers can improve patients symptoms, improve the mortality rate and reduce the number of hospital admissions, in the case of ACE inhibitors by around 30%.

Data from General Practice show that just under 50% of patients with heart failure are prescribed ACE inhibitors, 10% are prescribed beta-blockers and over 90% are prescribed diuretics.

Younger patients are more likely to be prescribed ACE inhibitors and beta-blockers compared to older patients. At all ages, women are less likely to receive treatment with ACE inhibitors than men.

The same data also show substantial variation in prescribing between individual practices, particularly for ACE inhibitors. Among the 211 practices contributing to the General Practice Research Database, the proportion of patients with treated heart failure currently prescribed ACE inhibitors, varied from 0% to 100%.

Data from the Heart of England Study, a population based screening study, show that levels of appropriate treatment are likely to be even lower than the GP Research database figures suggest. Overall, only 30% of those diagnosed with definite heart failure were receiving ACE inhibitor medication.

Between 1994 and 1998, the percentage of treated heart failure patients prescribed ACE inhibitors in the GP Research Database increased from 37% to 53% in men, and from 30% to 44% in women – an overall increase of over 40%. The percentage prescribed beta-blockers also increased, by 23% in men and 15% in women, but levels of prescribing remain relatively low compared to those for ACE inhibitors.