<International Circulation>: As an overview of the current state of heart failure management, what do you advocate as the important strategic steps in achieving desired results?
Dr Willenheimer: We have to have a multi-disciplinary approach. We definitely need to consider co-morbidities apart from the heart failure per se. Co-morbidities (anemia, COPD and so on) have received some attention recently but not adequate attention yet. Anemia particularly is very important - it is common; it decreases survival; it increases morbidity; and it appears to be reversible. Similarly iron deficiency, which is even more common than anemia and can exist in the absence of anemia as well. Iron deficiency also seems to be very important and you can reverse symptoms and improve quality of life by giving intravenous iron. Of course we need to improve on drugs and devices and there is a lot of research ongoing in that field but I think the most important thing is not just to focus on the heart and the heart failure but to consider the patient as a whole. To me, the most important individual factor is to prevent heart failure from developing at all – not just preventing heart failure in patients with pre-existing cardiovascular disease but also preventing cardiovascular disease from developing at the outset.
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