Four in 10 patients with chronic heart failure are not treated according to pan-European guidelines, according to a study in six countries.

Those who were on the recommended drug regimes were far less likely to be admitted to hospital and enjoyed longer periods before being readmitted, said research published in the European Heart Journal.

More than 1,400 patients, including 165 in Britain, were followed over six months and checked for adherence to guidelines from the European Society of Cardiology. Patients in France, Germany, Italy, the Netherlands and Spain were also monitored. Only 60% were treated according to guidance for the three drugs with most evidence of benefit: ACE-inhibitors, which act against an enzyme involved in narrowing arteries and raising blood pressure; beta-blockers; and spironolactone, a diuretic.

The treatment rates were similar across all countries.

Among patients treated with perfect adherence to guidance for the "big three", 6.7% were admitted with heart failure and 11.2% for a worsening of related cardiovascular symptoms. Rates for those on regimes which least matched the guidelines were 14.7% and 20%.