Tag Archives: angiotensin receptor blockers

The patients who developed cardiotoxicity were treated with beta blockers (carvedilol), angiotensin-converting enzyme inhibitors (enalapril) or angiotensin receptor blockers (valsartan), aldosterone antagonists (eplerenone), digitalis and diuretics (furosemide), as needed. When patients remained symptomatic and met the PARADIGM-HF inclusion criteria, sacubitril/valsartan was started instead of enalapril or valsartan. Results showed that sacubitril/valsartan therapy produced an improvement in ventricular remodelling, diastolic dysfunction, and on symptoms, reflected in the New York Heart Association class and the six-minute walk test. The auth

Landmark trials in heart failure – 30 years from CONSENSUS With 2017 marking the 30th year since the publication of CONSENSUS,1 which first reported a reduction in mortality with enalapril versus placebo in patients with advanced heart failure (HF), the BCS held a dedicated session to review the seminal clinical trials and advances in chronic heart failure management in this period. Dr Rosita Zakeri (Royal Brompton Hospital, London) reviewed this session for us and spoke to the BJC afterwards. Rosita Zakeri The era of vasodilator therapy for heart failure began in the 1990s. Professor Karl Swedberg (University of Gothenberg, Sweden) began

Our letter from Nepal below shows underuse of beta blockers is a widespread problem As outlined in the recent European Society of Cardiology (ESC) guidelines for the treatment of heart failure,1 the pivotal trials with beta blockers were conducted in patients with continuing symptoms and a persistently low ejection fraction (EF), despite treatment with an ACE inhibitor and, in most cases, a diuretic. Despite this, “there is consensus that these treatments are complementary and that a beta blocker and an ACE inhibitor should both be started as soon as possible after diagnosis of heart failure with reduced ejection fraction (HF-REF)”.1

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Controversial salt paper published A new European study has caused controversy by suggesting that lowering salt intake may not be beneficial. The study, published recently in JAMA (May 4th 2011 issue), was conducted by a team from the University of Leuven, Belgium. They followed 3,681 participants who were free of cardiovascular disease at baseline for a median of 7.9 years, and found an inverse relationship between cardiovascular deaths and 24-hour sodium excretion (which correlates to salt intake), although systolic blood pressure was higher with higher salt intake. But an editorial in the Lancet (May 12th 2011 issue) criticises the study,

The registry study, published in Journal of the American Medical Association (January 12th, 2011 issue), involved 30,254 patients, of whom 2,500 were taking losartan and 2,639 were taking candesartan. One-year survival was 90% for patients receiving candesartan and 83% for those taking losartan. Five-year survival was 61% and 44%, respectively. In multivariate analysis with adjustment for propensity scores, the hazard ratio for mortality for losartan compared with candesartan was 1.43 (p<0.001). The authors, led by Dr Maria Eklind-Cervenka (South Hospital, Stockholm, Sweden) note that the difference remained significant even after adjustme