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:10/13/2015)... ... October 13, 2015 , ... Vision Group Holdings, the largest LASIK provider in ... brands including The LASIK Vision Institute and TLC Laser Eye Centers, Vision Group Holdings ... laser vision correction. , Global Laser Vision will continue to operate in San Diego ...
(Date:10/13/2015)... ... October 13, 2015 , ... PhyMed Healthcare Group ... announced its partnership with WPC Healthcare , a provider of predictive analytics ... the data into an aggregated data repository necessary to perform reporting and analytics ...
(Date:10/13/2015)... ... October 13, 2015 , ... Symposium Chairman, Dr. Rod J. ... Dallas Cosmetic Symposium to be held March 2nd and 3rd, 2016. The annual meeting, ... plastic surgeons and cosmetic physicians from around the world. , Key topics at this ...
(Date:10/13/2015)... ... October 13, 2015 , ... e-con Systems Inc., a leading embedded design ... the industry’s first RGB-IR pixel format camera with a USB 3.0 interface and ... See3CAM family of UVC USB 3.0 cameras, is based on the 1/3-inch OV4682 - ...
(Date:10/13/2015)... ... October 13, 2015 , ... ... today their Title Sponsorship of Synergy 2015. The annual WennSoft KEY2ACT user conference ... Valley Ranch and will unite customers, partners, WennSoft team members and sponsors to ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... 13, 2015  Vitamin Angels – a charity that ... need of nutritional support - announced its work continues ... Nations (UN). The UN,s newly established Global Goals - ... recent follow up to the Millennium Development Goals established ... The new 17 Global Goals intend to address three ...
(Date:10/13/2015)... Generational Equity , a leading mergers and acquisitions advisor ... acquisition of its client, Quality Medical Rentals ... by Meridian Biomedical, Inc. (Meridian), headquartered in Colorado.  The ... Florida . To learn more, visit ... To learn more, visit . --> ...
(Date:10/13/2015)... -- The spine division of Zimmer Biomet (NYSE and SIX: ... its portfolio of innovative clinical solutions and technologies at ... 14-17, 2015, in Chicago , Illinois.  ... "Supplemental MIS Fixation Options for LLIF" NASS ... 1 p.m. --> "Supplemental MIS Fixation Options ...
Breaking Medicine Technology: