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Reassessing guidelines for heart failure

Medical University of Hanover, Germany, drexler.helmut{at}mh-hannover.de

Kai C Wollert

Medical University of Hanover, Germany

Significant progress has been made in the last few years in the management of heart failure. In particular, several trials have given significant results. It has become apparent that heart failure may be prevented in some patients by treatment of risk factors such as coronary artery disease.

Experience with angiotensin-converting enzyme (ACE) inhibitors has shown that the survival and symptomatic benefits do last in the long term, and confirm that they are the first-line treatment in heart failure.

The results of a number of trials using the angiotensin receptor blockers (ARBs) candesartan, valsartan and losartan are presented and discussed. There is also some experience now in the use of candesartan for patients with heart failure and preserved left ventricular systolic function.

The COMET trial compared the β-blockers carvedilol and metoprolol tartrate, and suggests that there may be differences in clinical effect between β-blockers.

The selective aldosterone receptor blocker eplerenone was evaluated in the EPHESUS trial in post-MI patients with signs of heart failure.

Based on these clinical trials, heart failure guidelines are now being updated.

Key Words: heart failure • guidelines • ACE inhibitors • angiotensin receptor blockers • β-blockers • aldosterone receptor blockade

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 5, No. 1 suppl, S28-S33 (2004)
DOI: 10.3317/jraas.2004.022


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Drexler, H. Articles by Wollert, K. C Search for Related Content PubMed PubMed Citation Articles by Drexler, H. Articles by Wollert, K. C Pubmed/NCBI databases Medline Plus Health Information Heart Failure Social Bookmarking                         What's this?