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The European Society of Cardiology has released new guidelines on heart failure that go beyond NICE in urging GPs to use triple drug therapy in all patients.

The society said the combination of ACE inhibitor and betablocker should no longer be considered sufficient.

Professor John Cleland, member of the guidelines taskforce, told Pulse: 'NICE does talk about ARBs, but not about the three together.

'The ESC guidelines suggest just using ACE inhibitors and betablockers is no longer optimal. Most patients with heart failure, certainly due to left ventricular systolic dysfunction, should be on a combination of ACE inhibitor, betablocker and an ARB or aldosterone receptor antagonist.'

The new guidelines, published in the European Heart Journal this week and discussed at the conference, also put further emphasis on the use of natriuretic peptides and promote the use of cardiac resynchronisation devices.

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