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GUIDELINES TOUTED AS WAY TO CUT HEART-RELATED DEATHS

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About 200,000 Americans die annually of heart failure, but the toll could be cut if doctors and patients follow new treatment guidelines, federal officials say.

The guidelines, released Tuesday by the Department of Health and Human Services, call for more aggressive use of cardiac drugs and stricter compliance by patients to doctors' orders."There is no question that we can help people to live longer with these guidelines," said Dr. Marvin A. Konstam, co-chairman of a panel that reviewed the guidelines and director of a heart unit at the New England Medical Center Hospitals in Boston.

The number of patients who would benefit can't now be measured, said Konstam, but he noted: "The number one point is that we have the ability now to prevent the progression of heart failure . . . therefore preventing people from dying and preventing hospitalizations."

Health-care experts said that if the guidelines are followed for the 2 million Americans with heart failure, it could cut hospitalizations for the disorder by 20 to 25 percent and save up to $3 billion.

"These guidelines are a timely and necessary step to improve quality of life for Americans," said Dr. Philip R. Lee, the HHS assistant secretary for health.

"Heart failure is a treatable illness that can be managed," he said. "Most persons with heart failure can adjust to the limitations imposed by the condition and continue to lead active and rewarding lives."

The heart failure treatment guidelines are targeted for patients who suffer from the most common type of heart failure, left-ventricular systolic dysfunction, which is poor blood circulation caused by weak pumping by the left chamber of the heart.

Heart failure symptoms include shortness of breath, fatigue, coughing that often disturbs sleep, the retention of fluid and swelling of the feet, ankles and legs.

Federal officials said the new guidelines would be distributed to doctors across the country and will then be available from the Government Printing Office. Additionally, the agency is issuing a companion brochure with specific patient instructions.

Lee said that doctors make inadequate use of cardiac drugs known as angiotensin-converting enzyme, or ACE, inhibitors. These drugs, he said, "help control heart failure symptoms and prolong life."

He also said patients often don't recognize the seriousness of medical orders to exercise, control diet and to take their medications.

The guidelines are based on an evaluation of more than 1,000 published studies.