Dr Alan Begg explores evidence-based guidance from SIGN on diagnosis, lifestyle modification, and interventions in chronic heart failure

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Read the Guidelines summary of SIGN guideline 147 on the Management of chronic heart failure for more recommendations on how to support patients with chronic heart failure


  1. Scottish Intercollegiate Guidelines Network. Management of chronic heart failure. SIGN 147. Edinburgh: SIGN, 2016. Available at: www.sign.ac.uk/guidelines/fulltext/147
  2. Scottish Intercollegiate Guidelines Network. Management of chronic heart failure. SIGN 95. Edinburgh: SIGN, 2007.
  3. NICE. Chronic heart failure in adults: management. NICE Clinical Guideline 108. NICE, 2010. Available at: www.nice.org.uk/guidance/cg108
  4. NICE. Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction. NICE Technology Appraisal Guidance 388. NICE, 2016. Available at: www.nice.org.uk/guidance/ta388
  5. McMurray J, Packer M, Desai A et al for the PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. New Engl J Med 2014; 371 (11): 993–1004.
  6. Desai A, McMurray J, Packer M et al. Effect of the angiotensin-receptor-neprilysin inhibitor LCZ696 compared with enalapril on mode of death in heart failure patients. Eur Heart J 2015; 36 (30): 1990–1997.
  7. Wise J. NICE approves innovative treatment for moderate to severe heart failure. News. BMJ 2016; 353: i2402.
  8. Swedberg K, Komajda M, Böhm M et al on behalf of the SHIFT Investigators. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376 (9744): 875–885.
  9. NICE. Implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure. NICE Technology Appraisal Guidance 314. NICE, 2014. Available at: www.nice.org.uk/guidance/ta314
  10. Freedland K, Carney R, Rich M et al. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Intern Med 2015; 175 (11): 1773–1782.
  11. Woltz P, Chapa D, Friedmann E et al. Effects of interventions on depression in heart failure: a systematic review. Heart Lung 2012; 41 (5): 469–483.
  12. British Society for Heart Failure.BSH Parliamentary Events: Questions asked at Scottish Parliament. Available at: www.bsh.org.uk/meetings/bsh-parliamentary-events/scotland-parliamentary-event/questions-asked-at-scottish-parliament/ (accessed 15 May 2016). G