Nutrition and Heart Failure: Impact of Drug Therapies and Management Strategies

作者：Dunn Steven P^*; Bleske Barry; Dorsch Michael; Macaulay Tracy; Van Tassell Benjamin; Vardeny Orly

来源：Nutrition in Clinical Practice, 2009, 24(1): 60-75.

DOI：10.1177/0884533608329299

• nutrition therapy
• heart failure
• vitamins
• electrolytes
• drug therapy

Nutrition impairment commonly occurs in patients with heart failure and affects disease progression. Vitamin and mineral deficiencies are associated with early mortality, particularly in patients classified as cachectic. Guideline-based therapies approved for heart failure, such as loop diuretics, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, aldosterone antagonists, and beta-adrenergic blockers, can lead to electrolyte abnormalities and predispose to some vitamin and micronutrient deficits. Clinical trial evidence in support of supplementary vitamin and mineral therapies for heart failure patients is limited with the exception of documented calcium and possibly vitamin D, thiamine, and coenzyme Q(10) deficiencies. This area is gaining significant attention, and research is ongoing. The clinician can help minimize morbidity from nutrition impairment through appropriate monitoring and correction of baseline and medication-induced electrolyte imbalances, in addition to vitamin and mineral supplementation when appropriate. (Nutr Clin Pract. 2009; 24: 60-75)

• 出版日期2009-3