Heart failure—optimal pharmacological therapy

Rocchiccioli, J. P. and McMurray, J. J.V. (2008) Heart failure—optimal pharmacological therapy. In: Beattie, J. and Goodlin, S. (eds.) Supportive Care in Heart Failure. Series: Supportive care series. Oxford University Press: Oxford ; New York, pp. 49-74. ISBN 9780198570288 (doi: 10.1093/acprof:oso/9780198570288.003.0004)

Abstract

This chapter addresses the state of knowledge in the evidence-based management of heart failure (HF) with medications. Diuretics were amongst the first therapies to be used in the treatment of HF. Angiotensin-converting enzyme (ACE) inhibitors are considered the first-line therapy in the management of HF with reduced left-ventricular systolic function. Angiotensin receptor blockers (ARBs) are the most recent class of drugs to be shown to be of benefit in HF. β-Blockers are considered the greatest advance in the treatment of HF since ACE inhibitors and lead to a further substantial reduction in mortality and morbidity. The mechanisms of action, clinical benefits, adverse effects and interactions, and practical uses of these therapies are reported. In addition, the mechanisms of action, clinical benefits, adverse effects and interactions, and practical uses of aldosterone antagonists, hydralazine and isosorbide dinitrate, and cardiac glycosides are described. It also explores the HF with preserved ejection fraction and other pharmacological therapies. Despite the impressive therapeutic armamentarium, patients with HF continue to experience progressive symptoms and shorter life expectancy.

• Item Type: Book Sections
• Status: Published
• Glasgow Author(s) Enlighten ID: Rocchiccioli, Dr John and McMurray, Professor John
• Authors: Rocchiccioli, J. P., and McMurray, J. J.V.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Publisher: Oxford University Press
• ISBN: 9780198570288