2021 ESC Guidelines updates for heart failure

Latest Research 11 October 2021

The European Society of Cardiology (ESC), a medical society with 100,000 cardiologists, nurse specialists and allied professional members, have released revised guidelines for the diagnosis and treatment of heart failure (HF).

Co-chaired by cardiologist Professor Theresa McDonagh of Kings College London, these guidelines include the latest research and evidence to advise on best practice. These are used globally to deliver the best care and outcomes for HF patients, and to support patients after diagnosis.

Whilst British practitioners follow NICE (National Institute for Health and Care Excellence) and SIGN (Scottish Intercollegiate Guidelines Network) to shape their care, they also refer to the ESC guidelines.

What updates are important to know, and what does this mean for patients?

Instead of taking three types of medication, patients with reduced ejection fraction are now recommended to take four drugs to improve the symptoms of their condition, reduce risk of death and improve their quality of life. These drugs are:

  • Beta Blockers (e.g. bisoprolol)
  • ACE inhibitor* (e.g. Ramipril) or ARNI (Entresto)
  • Mineralocorticoid receptor antagonist (MRA) (e.g. spironolactone)
  • SGLT2 inhibitor (e.g. dapagliflozin). 

*(An ARB (Angiotensin receptor blocker, e.g. Cadesartan) may be prescribed for people intolerant of ACE.)

For patients who have water retention, it is also recommended to take a diuretic (water tablet). The guidelines also consider the investigation of cardiomyopathy patients and individuals with myocarditis, and make recommendations about genetic testing and counselling.

There is a strong emphasis on helping patients to help themselves through education about their condition, by providing psychosocial support to patients and family members, and by supporting home-based or centre-based rehabilitation. This is a welcome introduction of fresh, evidence-based recommendations for the long-term care of people with cardiomyopathy.

If you’d like to understand more about your or a loved one’s condition and how to manage life with cardiomyopathy, you can call our helpline on 0800 018 1024 or order our free information resources. We also have support groups, where you can speak to others, as well as advice on emotional wellbeing.

Return to news