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Heart Failure Drugs Put to the Test
Date:11/27/2012

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
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