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

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 drug
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