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Utilization and Dose Optimization of Angiotensin-Converting Enzyme Inhibitors among Heart Failure Patients in Southwest Ethiopia

Niriayo, YL, Kumela, K, Gidey, K and Angamo, MT 2019 , 'Utilization and Dose Optimization of Angiotensin-Converting Enzyme Inhibitors among Heart Failure Patients in Southwest Ethiopia' , BioMed Research International , pp. 1-8 , doi:

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Background: Optimal use of angiotensin-converting enzyme inhibitors (ACEIs) is crucial to improve the treatment outcome in heartfailure patients. However, little is known about the optimal use of ACEIs among heart failure patients in our setting. Terefore, ourstudy aimed to investigate the utilization and optimal dosing of ACEIs and associated factors in heart failure patients. Method:A cross-sectional study was conducted on randomly selected patients with heart failure between February 2016 and June 2016 atambulatory care clinic of Jimma University Medical Center, Ethiopia. Data were collected through patient interview and review ofmedical records. Binary logistic regression analysis was done to identify factors associated with utilization and optimal dosing ofACEIs. Results: A total of 308 patients were included in the fnal analysis of this study. Te mean (±standard deviation) age of thepatients was 52.3 ±15.5 years. Out of the total, 74.7% of the patients were receiving ACEIs. Among the patients who were receivingACEIs, only 35.7% were taking optimal dose. New York Heart Association (NYHA) class III (Adjusted odds ratio (AOR):0.12, 95%confdence interval (CI):0.02–0.98), valvular heart disease (AOR: 0.27, 95% CI: 0.13-0.56), hypertension (AOR: 5.82, 95% CI: 2.16-15.71), and diabetes mellitus (AOR: 3.84, 95% CI: 1.07-13.86) were signifcantly associated with the use of ACEIs, whereas age ≥65(AOR: 2.61, 95%CI: 1.20-5.64), previous hospitalization for heart failure (AOR: 2.08, 95%CI: 1.11-3.92), diuretic use (AOR: 5.60,95%CI: 2.75-11.40), and dose of furosemide >40mg (AOR: 9.80, 95%CI: 3.00-31.98) were predictors of suboptimal dosing of ACEIs.Conclusion: Although majority of patients were receiving ACEIs, only about one-third were using optimal dosage. Valvular heartdisease and NYHA class III were negatively associated with the use of ACEIs while previous hospitalization for heart failure, old age,diuretic use, and diuretic dose were predictors of suboptimal dosing of ACEIs. Terefore, more efort needs to be done to minimizethe potentially modifable risk factors of suboptimal use of ACEIs therapy in heart failure patients.

Item Type: Article
Authors/Creators:Niriayo, YL and Kumela, K and Gidey, K and Angamo, MT
Journal or Publication Title: BioMed Research International
Publisher: Hindawi Publishing Corporation
ISSN: 2314-6133
DOI / ID Number:
Copyright Information:

Copyright © 2019 Yirga Legesse Niriayo et al. This is an open access article distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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