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Is too much neurohormonal blockade harmful?

Inder S Anand1

  • 1VA Medical Center, One Veterans Drive, 111-C, Minneapolis, MN 55417, USA. anand001@umn.edu

Current Cardiology Reports
|April 13, 2004
PubMed

Insights

Heart failure treatments targeting the sympathetic and renin-angiotensin-aldosterone systems improve survival. However, blocking other neurohormones offers limited benefit, suggesting a ceiling effect in heart failure therapy.

Area of Science:

  • Cardiology
  • Neuroendocrinology
  • Pharmacology

Background:

  • Neurohormones and cytokines are activated in heart failure, influencing disease progression.
  • Established therapies targeting the sympathetic nervous system and renin-angiotensin-aldosterone system significantly improve heart failure patient survival.

Purpose of the Study:

  • To review studies on neurohormonal blockade in heart failure.
  • To analyze the reasons behind the limited efficacy of inhibiting certain neurohormones and cytokines.

Main Methods:

  • Review of existing clinical studies and research on heart failure pharmacotherapy.
  • Analysis of data regarding the effects of various neurohormonal blockade strategies.

Main Results:

  • Inhibition of the sympathetic and renin-angiotensin-aldosterone systems with specific drugs (e.g., beta-blockers, ACE inhibitors) is effective.
  • Targeting other neurohormones and cytokines has not yielded expected benefits and can be detrimental.

Conclusions:

  • There may be a limit to the benefits of further neurohormonal blockade in heart failure.
  • Understanding these limitations is crucial for developing future heart failure treatment strategies.

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