Navigation Links
Heart Failure Drugs Put to the Test

By Randy Dotinga
HealthDay Reporter

TUESDAY, Nov. 27 (HealthDay News) -- Two new studies examine the effectiveness of medications frequently prescribed for heart failure -- the heart's inability to pump blood properly throughout the body.

For the 5.7 million Americans who suffer from heart failure, shortness of breath and edema (excessive water retention) can hinder normal activities. Advances in medication have dramatically changed the lives of some patients, but the question facing cardiologists is: What drugs should they prescribe for this difficult-to-treat condition?

"Treatment can be difficult because of low blood pressure or kidney disease," said study lead author Dr. Adrian Hernandez. "Other conditions such as depression make it harder for patients to adhere to their medications." And patients with heart failure "are at high risk for mortality or hospitalization for worsening heart failure," he explained. (About 55,000 die of heart failure each year.)

The two studies are published in the Nov. 28 issue of the Journal of the American Medical Association.

One of the new studies looks at the effectiveness of aldosterone antagonists for heart failure patients who have what's called "reduced ejection fraction," which means they have a particularly poor prognosis.

Patients with this condition make up about 40 percent to 50 percent of those with heart failure, said Dr. Justin Ezekowitz, an associate professor with the University of Alberta, Canada, who was not involved with the study.

Aldosterone antagonists are diuretics that help the body get rid of excess water. They include eplerenone (Inspra) and spironolactone (Aldactone).

The new study provides "the real world" perspective on aldosterone antagonists, said Hernandez, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.

The study of 5,887 patients, average age 78, found that those who took the drugs after hospital discharge were 13 percent less likely than those not taking the drugs to be readmitted to the hospital for heart failure within three years. However, among this elderly population the drug didn't appear to improve their risk of death or readmission for heart problems in general.

"These drugs look like they're useful, but we have to be careful before prescribing these medications in a general group of patients," said Ezekowitz. "At this point, we haven't shown that you absolutely should start these drugs."

Those who take these drugs face a risk of high potassium levels and should have their potassium and kidney function monitored, Ezekowitz said.

The other study examined drugs known as angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers for treating heart failure patients with so-called "preserved ejection fraction." This means their hearts seem to pump properly, at least judging by screening tests, but they're still weaker than they should be, Ezekowitz said.

ACE inhibitors, such as captopril (Capoten) and enalapril (Vasotec), are commonly used to treat high blood pressure. So are angiotensin receptor blockers, such as telmisartan (Micardis) and eprosartan (Teveten).

For the study, the researchers used a Swedish registry to identify more than 16,200 patients, average age 75, and treated about 12,500 of them. In one analysis, the researchers found the risk of death from all causes over a year fell by about 20 percent among patients who took the drugs, but the study authors said more research is needed to confirm the results. (About a quarter of patients died.)

Overall, Ezekowitz said, the evidence so far supports prescribing the drugs in the two studies as first-line treatments in heart failure patients with complicating conditions such as diabetes and high blood pressure. But in general, he said, "we haven't shown you absolutely should start these drugs."

The drugs in the two studies are relatively inexpensive, he noted.

More information

For more about heart failure, visit the U.S. National Library of Medicine.

SOURCES: Justin A. Ezekowitz, MBBCh, assistant professor, University of Alberta, Edmonton, Canada; Adrian F. Hernandez, M.D., associate professor of medicine, Duke University School of Medicine, Durham, N.C.; Nov. 28, 2012, Journal of the American Medical Association

Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Witnessing, Experiencing Traumatic Events May Worsen Heart Disease
2. Risk of suicide and fatal heart attack immediately following a cancer diagnosis
3. Cancer Diagnosis May Raise Odds for Suicide, Heart Attack Death
4. In children born with severe heart defect, surgical management has little effect on neuro outcomes
5. Invasive heart test being dramatically overused, Stanford study shows
6. Heart failure patients with diabetes may benefit from higher glucose levels
7. Omega-3 Supplements No Help Against Repeat Heart Trouble: Review
8. EKG Heart Test May Predict Risk in Older Adults
9. Common Blood Pressure Drug Safe for Heart Failure: Study
10. Spouses of Cancer Patients May Have Raised Risk of Heart Disease, Stroke
11. SMART heart eases heart ache, targets cardiac patients emotional well-being
Post Your Comments:
Related Image:
Heart Failure Drugs Put to the Test 
(Date:11/25/2015)... , ... November 25, 2015 , ... ... has focused on providing comprehensive solutions involving adult stem cell therapies to patients ... officially deemed the “Regenestem” name as a Registered Trademark (RTM). , Organizations are ...
(Date:11/25/2015)... ... 25, 2015 , ... Bunion Bootie , the newest ... of the early holiday shopping season. Starting Wednesday November 25th, Bunion Booties are ... Friday promotional pricing is in addition to any automatic discounts applied when buying ...
(Date:11/24/2015)... ... November 24, 2015 , ... Eric C. Seidel, ... many benefits of the revolutionary BIOLASE WaterLase iPlus 2.0™ system. This advanced laser ... used by a dentist in Gettysburg, PA . From routine visits to ...
(Date:11/24/2015)... ... , ... New patients who wish to seek treatment for missing teeth can ... her Mississauga, ON practice. Dr. Williams has been providing dental service for over 34 ... Missing teeth can lead to a variety of complications if they are not replaced ...
(Date:11/24/2015)... ... ... Charitable giving is at its peak during the holidays. In fact, ... the year totalling over $358 billion in 2014. With more than 1.5 million ... individuals who want to “give back” during the holidays. , “With so many charities ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... 2015 Research and Markets ( ) ... - Global Forecast to 2020" report to their ... for 37.21% of the total market share in 2014. ... region is projected to growth at the highest CAGR ... primarily to the fast growing water, industrial gas treatment, ...
(Date:11/24/2015)... 25, 2015 WuXi PharmaTech (Cayman) Inc. ("WuXi" ... open-access R&D capability and technology platform company serving the ... China and the ... extraordinary general meeting of shareholders held today, the Company,s ... and approve the previously announced agreement and plan of ...
(Date:11/24/2015)... N.C. , Nov. 24, 2015  In the ... projects in an effort to quickly uncover new insights, ... --> --> However, ... a market research project and ensure that all rules ... and industry standards. Another major barrier to efficiently launching ...
Breaking Medicine Technology: