Quadruple Therapy in HFrEF Treatment

Quadruple Therapy in HFrEF Treatment: A Comprehensive Guide

Doctors and cardiologists are incredibly excited about quadruple therapy! It’s a major leap forward in helping patients with Heart Failure with Reduced Ejection Fraction (HFrEF) live longer, healthier lives. Quadruple therapy is quickly becoming the gold standard—the first line of defense for patients whose hearts aren’t pumping as effectively as they should. Studies are showing massive benefits, especially in reducing mortality rates and hospitalizations.

Shall we get to the heart of it?

What is Quadruple Therapy for HFrEF?

Heart Failure with Reduced Ejection Fraction (HFrEF) means the heart isn’t pumping blood as effectively as it should. Think of your heart as a pump with chambers that contract and relax to push blood throughout your body.

Ejection fraction (EF) is how much blood the left ventricle pumps out with each beat. A normal EF is between 50-70%, but in HFrEF, it’s usually below 40%. This means your heart can’t pump enough blood to meet your body’s needs.

What is Quadruple Therapy?

Quadruple Therapy combines four medications to treat HFrEF. These medications work together to improve how your heart functions and ease symptoms:

• ACE Inhibitors or ARBs: These lower your blood pressure and reduce the strain on your heart.
• Beta-Blockers: They slow your heart rate and make your heart work more efficiently.
• Mineralocorticoid Receptor Antagonists (MRAs): These help reduce fluid buildup and balance important minerals in your body.
• SGLT2 Inhibitors: A newer class of drugs that improves kidney function and protects against heart failure complications.

What Was the Standard Treatment Before Quadruple Therapy?

Before Quadruple Therapy, doctors relied on three medications:

• ACE Inhibitors or ARBs for blood pressure control
• Beta-Blockers to slow the heart rate
• MRAs to manage fluid buildup

Quadruple Therapy is a huge breakthrough in treating heart failure, similar to how Ozempic changed the game for diabetes and weight loss.

Here’s why it matters:

• Cuts mortality: Quadruple therapy reduces the risk of death from heart failure. This is a big deal, especially when heart failure was once so hard to treat.
• Improves your life: It eases symptoms like shortness of breath and fatigue, helping you live a fuller, more active life.
• The new standard: Quadruple therapy is now the go-to treatment for HFrEF and is changing how doctors approach heart failure care worldwide.

Why Quadruple Therapy is Important for HFrEF

Quadruple therapy, which combines ARNI, beta-blockers, MRAs, and SGLT2 inhibitors, significantly improves survival, reduces hospitalizations, and enhances the quality of life for patients with Heart Failure with Reduced Ejection Fraction (HFrEF). Here’s why this combination is essential for managing HFrEF:

1. Improves survival rates

Studies show that quadruple therapy can increase survival by up to 8 years for a 55-year-old heart failure patient.

2. Decreases mortality

Quadruple therapy can potentially add 6 years of life to patients with HFrEF, helping them live longer with fewer complications.

3. Reduces hospitalizations

By improving heart function and reducing symptoms, it significantly cuts down on hospital admissions due to heart failure exacerbations.

4. Enhances quality of life

Patients on quadruple therapy experience better overall health, with fewer symptoms like fatigue, shortness of breath, and swelling.

5. Effective in poor renal function

Even in patients with renal issues, these therapies reduce mortality and morbidity, making them vital even in high-risk patients.

6. Broad benefits

New drug classes like SGLT2 inhibitors are now proving effective in treating not only HFrEF but also other forms of heart failure, like HFmrEF and HFpEF.

Quadruple therapy is a proven, life-extending treatment for HFrEF patients. In fact, a study published in JAMA Cardiology found that if every qualified patient took these meds, we could save 1.19 million lives worldwide. That’s the power of this treatment.

Who Should Use Quadruple Therapy for HFrEF?

Quadruple therapy isn’t for the otherwise healthy. It’s designed for people with heart failure. If you have heart failure, you should be started on quadruple therapy, unless there are specific contraindications preventing it.

DISCLAIMER: This article should not be taken as medical advice. If you’re worried about your symptoms, see a doctor immediately.

What Are the Side Effects of Quadruple Therapy?

Quadruple therapy works wonders, but like any treatment, it can come with some side effects. Here’s what you might experience with each of the medications:

ACE Inhibitors/ARBs
These meds can sometimes affect kidney function, especially if you already have kidney issues.

• High potassium (hyperkalemia)
• Low blood pressure
• Dizziness
• Kidney issues (in some cases)

Beta-Blockers
While they help reduce strain on the heart, they may leave you feeling a bit sluggish at times.

• Fatigue
• Slower heart rate
• Dizziness
• Low blood pressure

Mineralocorticoid Receptor Antagonists (MRAs)
MRAs help reduce fluid buildup but can increase potassium levels, so regular checks are important.

• High potassium
• Kidney issues
• Low blood pressure

SGLT2 Inhibitors
These newer meds support kidney health, but dehydration and other issues can sometimes crop up.

• Urinary tract infections (UTIs)
• Dehydration
• Low blood pressure
• Kidney issues

Managing Side Effects
The good news is that regular monitoring by your healthcare provider can help keep side effects in check. Blood tests, blood pressure checks, and kidney function assessments ensure your treatment is safe and effective.

Your doctor can adjust your medication as needed to minimize risks and maximize benefits.

Own Your Heart Health

We believe in empowering you to take control of your heart health. While quadruple therapy is the global standard for treating HFrEF, the reality is that many patients still don’t receive this life-saving treatment. In fact, a 2023 American Heart Association study found that:

• 6% of patients aren’t on quadruple therapy at all
• Only 19% are on at least one of the four meds
• Only 43% use two of the four medications
• Only 28% are on three of the four meds
• Really, only 3% are truly on quadruple therapy

Despite quadruple therapy being the standard of care, this is the disheartening truth. Whether it’s because doctors are slow to adopt newer treatments, or medications aren’t accessible due to coverage issues, the solution is there—but it’s still not reaching everyone.

At Yunique Medical, we don’t just treat—we educate. You deserve the best care and the tools to take an active role in your treatment plan. Your heart’s steady beat is your lifeline, and with just one heart to rely on, now is the time to make choices that will impact your health for the next decade and beyond.

Talk to us at any of our locations:

Port Orange, FL
Fruitland Park, FL
Ocala, FL

Ready to take control of your heart health? Contact us today and let’s work together to create a treatment plan that works for you.